Risk Factors for Home Care Discontinuation Among Older People With Dysphagia: A Two-Year Retrospective Cohort Study.

IF 3.1 3区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of oral rehabilitation Pub Date : 2025-05-02 DOI:10.1111/joor.13999

Hiroyasu Furuya, Takeshi Kikutani, Tomohito Sakazume, Yujiro Nakazawa, Kumi Tanaka, Yoko Kato, Yoko Ichikawa, Akari Hatano, Maiko Ozeki, Takashi Tohara, Noriaki Takahashi, Fumiyo Tamura

{"title":"Risk Factors for Home Care Discontinuation Among Older People With Dysphagia: A Two-Year Retrospective Cohort Study.","authors":"Hiroyasu Furuya, Takeshi Kikutani, Tomohito Sakazume, Yujiro Nakazawa, Kumi Tanaka, Yoko Kato, Yoko Ichikawa, Akari Hatano, Maiko Ozeki, Takashi Tohara, Noriaki Takahashi, Fumiyo Tamura","doi":"10.1111/joor.13999","DOIUrl":null,"url":null,"abstract":"Background: Receiving home care improves the quality of life of older adults. Nonetheless, limited studies have examined factors influencing pneumonia onset and home care discontinuation in older adults living at home.Objective: To clarify the factors associated with home care discontinuation in older adults receiving home care for dysphagia and to identify risk factors for home care discontinuation.Methods: This study included 162 adults (≥ 65 years) with dysphagia who were receiving home care. Nutritional status, history of pneumonia, swallowing function, activities of daily living, and comorbidities were assessed. The study participants were followed up for 2 years. Factors associated with home care discontinuation (death and hospitalisation) were analysed using the Kaplan-Meier method and Cox proportional hazards model.Results: During the 2-year follow-up, 110 (67.9%) participants discontinued home care (35 due to pneumonia, 75 due to other causes). Severe dysphagia was the strongest risk factor for pneumonia-induced discontinuation (HR = 3.25, 95% CI: 1.35-7.83). Malnutrition (HR = 2.32, 95% CI: 0.93-5.76) and pneumonia history (HR = 2.00, 95% CI: 1.00-4.35) elevated pneumonia-related risk. Severe dysphagia (HR = 1.52, 95% CI: 0.65-3.55) and malnutrition (HR = 1.58, 95% CI: 0.95-2.64) were potential risk factors for non-pneumonia-induced discontinuation.Conclusion: In older adults receiving home care, severe dysphagia was a major risk factor for home care discontinuation, with malnutrition and a history of pneumonia suggested as potential contributing factors. These findings indicate that improving nutritional status, maintaining and enhancing swallowing function and providing appropriate management for individuals with a history of pneumonia are crucial for ensuring continuous home care.","PeriodicalId":16605,"journal":{"name":"Journal of oral rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.1000,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of oral rehabilitation","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1111/joor.13999","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"DENTISTRY, ORAL SURGERY & MEDICINE","Score":null,"Total":0}

引用次数: 0

Abstract

Background: Receiving home care improves the quality of life of older adults. Nonetheless, limited studies have examined factors influencing pneumonia onset and home care discontinuation in older adults living at home.

Objective: To clarify the factors associated with home care discontinuation in older adults receiving home care for dysphagia and to identify risk factors for home care discontinuation.

Methods: This study included 162 adults (≥ 65 years) with dysphagia who were receiving home care. Nutritional status, history of pneumonia, swallowing function, activities of daily living, and comorbidities were assessed. The study participants were followed up for 2 years. Factors associated with home care discontinuation (death and hospitalisation) were analysed using the Kaplan-Meier method and Cox proportional hazards model.

Results: During the 2-year follow-up, 110 (67.9%) participants discontinued home care (35 due to pneumonia, 75 due to other causes). Severe dysphagia was the strongest risk factor for pneumonia-induced discontinuation (HR = 3.25, 95% CI: 1.35-7.83). Malnutrition (HR = 2.32, 95% CI: 0.93-5.76) and pneumonia history (HR = 2.00, 95% CI: 1.00-4.35) elevated pneumonia-related risk. Severe dysphagia (HR = 1.52, 95% CI: 0.65-3.55) and malnutrition (HR = 1.58, 95% CI: 0.95-2.64) were potential risk factors for non-pneumonia-induced discontinuation.

Conclusion: In older adults receiving home care, severe dysphagia was a major risk factor for home care discontinuation, with malnutrition and a history of pneumonia suggested as potential contributing factors. These findings indicate that improving nutritional status, maintaining and enhancing swallowing function and providing appropriate management for individuals with a history of pneumonia are crucial for ensuring continuous home care.

查看原文本刊更多论文

老年吞咽困难患者停止家庭护理的危险因素：一项为期两年的回顾性队列研究。

背景：接受家庭护理可以提高老年人的生活质量。尽管如此，有限的研究调查了影响住在家里的老年人肺炎发病和停止家庭护理的因素。目的：阐明因吞咽困难而接受居家护理的老年人中止居家护理的相关因素，并确定中止居家护理的危险因素。方法：本研究纳入162名接受家庭护理的成人（≥65岁）吞咽困难患者。评估营养状况、肺炎史、吞咽功能、日常生活活动和合并症。研究参与者被随访了2年。使用Kaplan-Meier方法和Cox比例风险模型分析与停止家庭护理（死亡和住院）相关的因素。结果：在2年的随访中，110名（67.9%）参与者停止了家庭护理（35名因肺炎，75名因其他原因）。严重吞咽困难是肺炎所致停药的最大危险因素（HR = 3.25, 95% CI: 1.35-7.83）。营养不良（HR = 2.32, 95% CI: 0.93-5.76）和肺炎史（HR = 2.00, 95% CI: 1.00-4.35）增加了肺炎相关风险。严重吞咽困难（HR = 1.52, 95% CI: 0.65-3.55）和营养不良（HR = 1.58, 95% CI: 0.95-2.64）是非肺炎所致停药的潜在危险因素。结论：在接受家庭护理的老年人中，严重的吞咽困难是家庭护理中断的主要危险因素，营养不良和肺炎史被认为是潜在的影响因素。这些发现表明，改善营养状况、维持和增强吞咽功能以及为有肺炎病史的个体提供适当的管理对于确保持续的家庭护理至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Journal of oral rehabilitation 医学-牙科与口腔外科

CiteScore

5.60

自引率

10.30%

发文量

116

审稿时长

4-8 weeks

期刊介绍： Journal of Oral Rehabilitation aims to be the most prestigious journal of dental research within all aspects of oral rehabilitation and applied oral physiology. It covers all diagnostic and clinical management aspects necessary to re-establish a subjective and objective harmonious oral function. Oral rehabilitation may become necessary as a result of developmental or acquired disturbances in the orofacial region, orofacial traumas, or a variety of dental and oral diseases (primarily dental caries and periodontal diseases) and orofacial pain conditions. As such, oral rehabilitation in the twenty-first century is a matter of skilful diagnosis and minimal, appropriate intervention, the nature of which is intimately linked to a profound knowledge of oral physiology, oral biology, and dental and oral pathology. The scientific content of the journal therefore strives to reflect the best of evidence-based clinical dentistry. Modern clinical management should be based on solid scientific evidence gathered about diagnostic procedures and the properties and efficacy of the chosen intervention (e.g. material science, biological, toxicological, pharmacological or psychological aspects). The content of the journal also reflects documentation of the possible side-effects of rehabilitation, and includes prognostic perspectives of the treatment modalities chosen.