PRANDIAL ASPIRATION AND PNEUMONIA IN AN ELDERLY POPULATION FOLLOWED OVER 3 YEARS

The purpose of our study was to prospectively determine pneumonia freq uency and correlate it with prandial liquid aspiration and feeding sta tus in frail elderly nursing home residents. Initially, 152 patients h ad video swallowing examinations (81 oropharyngeal dysphagia, 19 thora cic dysphagia, 52 without dysphagia). Those diagnosed with oropharynge al impairment were subsequently managed with swallowing therapy or art ificial feeding modalities. Patients were followed for 3 years (unless they expired earlier) and clinical courses were categorized according to the degree of prandial aspiration and feeding (PAF) status. Subjec ts with new lung infiltrates persisting for at least 5 days with appro priate clinical findings were diagnosed as having pneumonia and were c lassified according to the PAF status months in which these findings o ccurred. Fifty-six pneumonias were diagnosed during 4,280 months with the following frequencies: no aspiration months 0.6%; minor aspiration months 0.9%; major aspiration/oral feeding months 1.3%; major aspirat ion/artificial feeding months 4.4%, p < 0.001. Our results indicate th at there is not a simple and obvious relation between prandial liquid aspiration and pneumonia. Artificial feeding does not seem to be a sat isfactory solution for preventing pneumonia in elderly prandial aspira tors.