Pilot study for risk assessment of aspiration pneumonia

Abstract

Background: Aspiration pneumonia is serious problem of elderly patients. It is important to objectively assess and control the risk factors of aspiration pneumonia. Aim: The purpose of this study was to clarify procedure objectively evaluating the risk of aspiration pneumonia in clinical situation and control them. Methods: We examined 62 elderly adults, aged older than 50 years, who were admitted to our hospital and agreed to participate in this study. We evaluated the number of bacteria in the oral cavity, the oral hygiene situation (OHAT), performance status (PS) and serum biomarker among 3 groups (aspiration pneumonia (AP), community acquired pneumonia(CP), and control). For serum markers, albumin was measured as a factor related to nutrition. CRP, CRP / Alb and WBC were also measured as serological evaluation of inflammatory response. During hospitalization, we conducted oral care by nurses. Result: OHAT score at the time of admission was 5.13±0.178 in the AP group, 4.40±0.255 in the CP group and 3.90±0.216 in the control. PS of the AP group (2.7±1.0) was significantly worse than that of the CP (1.6±0.6) . We also observed significant differences among three groups in BMI, albumin, CRP and WBC. Oral bacterial count (logarithm) in the AP group (7.20±0.110) was significantly greater than that in the CP group (6.89±0.115), which is comparable to OHAT score. In addition, oral bacterial count was significantly reduced by oral care. Conclusion: OHAT and bacterial count are useful for assessing the risk of aspiration pneumonia and the effect of oral care by nurses.