Risk Factors Associated with Oral Intake Discontinuation in Hospitalized Patients with Aspiration Pneumonia: A Scoping Review.

Abstract

Background: Aspiration pneumonia is a prevalent condition, and understanding the risk factors associated with discontinuation of oral intake upon discharge is crucial. This study aimed to identify such factors, thereby providing valuable insights for optimizing the use of limited healthcare resources and enhancing patient and family care.

Methods: In this scoping review, data were collected through ICHUSHI using the search formula "Pneumonia-Aspiration/Thesaurus or Aspiration Pneumonia/All) and (Prognosis/Thesaurus or Prognosis/All)." The inclusion criteria encompassed Japanese patients hospitalized for aspiration pneumonia, with a clear outcome focused on the availability of oral intake. The exclusion criteria included text unavailability, studies from foreign countries, and cases involving not hospitalized patients. The risk of bias for each study was assessed using the Newcastle-Ottawa scale.

Results: Using this search formula, 1,646 articles were initially identified, culminating in the inclusion of six articles for analysis. The investigation revealed five significant risk factors: social status (age and gender), nutritional status (body mass index, Controlling Nutritional Status score, serum albumin, Basal Energy Expenditure, and low body weight), physical swallowing function (ambulatory ability before admission, Food Intake LEVEL scale (FILS), admission origin, bedridden status, Penetration-Aspiration scale, presence of residual pharyngeal material, and Basal Index), pneumonia severity (A-DROP score, a classification tool incorporating age, dehydration, oxygen demand, impaired consciousness, and hypotension), and comorbidities (pneumonia, dementia, mental illness, malignancy, chronic lower respiratory tract involvement, and renal failure).

Conclusions: This scoping review identified five key risk factors associated with oral intake discontinuation upon discharge in patients hospitalized for aspiration pneumonia, providing valuable evidence for future clinical practice.