Hibberd Judi, Fraser Jenni, Chapman Claire, McQueen Hannah, Wilson Adrian
Coventry and Warwickshire Partnership Trust, Nuneaton 18 Hodgetts Lane, Burton Green, Kenilworth, Warwickshire, CV8 1PJ, UK.
Multidiscip Respir Med. 2013 Jun 11;8(1):39. doi: 10.1186/2049-6958-8-39.
The current study builds upon the work of others in looking at influencing factors of aspiration pneumonia in people with a swallowing problem. This study differs from previous researches on this topic, focusing on the United Kingdom (UK) population and involving more recently defined influencing factors of aspiration pneumonia. The study aims to explore the multifactorial nature of aspiration pneumonia in a UKdysphagic client group, as well as different disease specific variables.
Speech and Language Therapists collected data on 33 influencing factors over a period of 6 months during routine bedside swallowing assessment of 687 patients. All subjects were adults referred with suspected dysphagia and included acute inpatients, head and neck cancer patients and adults with learning disabilities. The study population included 400 males and 287 females and ages ranged from 17 to 102 giving a mean age of 72.9 years. The influence of the different variables included in the study was evaluated using multivariate logistic regression analysis.
The results show that 13 statistically significant influencing factors were implicated in the development of aspiration pneumonia for this group. Out of these, nine correlate with the previous work undertaken in the United States. These were poor mobility, nil by mouth status, age, dependency for feeding, number of medications, Chronic Obstructive Pulmonary Disease (COPD), number of medical conditions, stroke and alcohol abuse. Four further influencing factors were shown to be significant in the UK population, these were dysphagia, only oral intake, bedfast, and male gender.
This study confirms that in the UK there are influencing factors in the development of an aspiration pneumonia. It would be prudent to remember that a direct link is yet to be established when applying this knowledge to inform clinical management.
本研究基于其他相关研究，着眼于吞咽困难人群中吸入性肺炎的影响因素。本研究与以往关于该主题的研究不同，聚焦于英国人群，并纳入了近期确定的吸入性肺炎影响因素。该研究旨在探讨英国吞咽困难患者群体中吸入性肺炎的多因素性质，以及不同疾病的特定变量。
言语和语言治疗师在对687例患者进行常规床边吞咽评估的6个月期间，收集了33个影响因素的数据。所有受试者均为疑似吞咽困难的成年人，包括急性住院患者、头颈癌患者和有学习障碍的成年人。研究人群包括400名男性和287名女性，年龄范围为17至102岁，平均年龄为72.9岁。使用多因素逻辑回归分析评估研究中纳入的不同变量的影响。
结果显示，该组中13个具有统计学意义的影响因素与吸入性肺炎的发生有关。其中，9个与美国此前的研究结果相关。这些因素包括行动不便、禁食状态、年龄、进食依赖、药物数量、慢性阻塞性肺疾病（COPD）、疾病数量、中风和酗酒。另外4个影响因素在英国人群中显示出显著意义，分别是吞咽困难、仅经口摄入、卧床不起和男性性别。
本研究证实，在英国，存在影响吸入性肺炎发生的因素。在应用这些知识为临床管理提供依据时，应谨慎记住，目前尚未建立直接联系。
