Hasumi Yuki, Hirota Yoshito, Nishimura Masahiro
Department of General Medicine Mogami Municipal Hospital Yamagata Japan.
Department of Healthcare Economics and Quality Management, Graduate School of Medicine Kyoto University Kyoto Japan.
J Gen Fam Med. 2022 Jun 13;23(5):336-342. doi: 10.1002/jgf2.564. eCollection 2022 Sep.
Decreased swallowing function is an important risk factor for the development of aspiration pneumonia. A previous study reported that a long duration of fasting decreased swallowing function and increased mortality. The purpose of this study is to clarify the relationship between weekend hospitalization and fasting duration in older patients with aspiration pneumonia.
In this retrospective cohort study using hospital claims data and electronic medical record data between April 1, 2018, and March 31, 2020, 238 patients hospitalized for aspiration pneumonia were enrolled. Patients admitted from Monday to Friday were defined as the weekday admission group, and patients admitted on Saturday, Sunday, and holidays were defined as the weekend admission group. The primary endpoint was the duration of fasting. Multiple regression analysis was performed with age, gender, place of living, Functional Oral Intake Scale before admission, severity of pneumonia, and weekend admission as the independent variables.
There were 41 patients in the weekend admission group and 103 patients in the weekday admission group. The baseline characteristics of the two groups were similar. There was a median difference in the fasting duration of 23.3 h; the fasting duration in the weekend admission group was significantly longer than the weekday admission group by 20.03 h (95% confidence interval: 2.81-37.25) in the multiple regression analysis.
Weekend hospitalization was significantly associated with a longer fasting duration in patients hospitalized for aspiration pneumonia. There is a need to establish a system to enable early meal initiation for patients admitted on weekends.
吞咽功能下降是吸入性肺炎发生的重要危险因素。先前的一项研究报告称,长时间禁食会降低吞咽功能并增加死亡率。本研究的目的是阐明老年吸入性肺炎患者周末住院与禁食时间之间的关系。
在这项回顾性队列研究中,使用了2018年4月1日至2020年3月31日期间的医院理赔数据和电子病历数据,纳入了238例因吸入性肺炎住院的患者。周一至周五入院的患者被定义为工作日入院组,周六、周日和节假日入院的患者被定义为周末入院组。主要终点是禁食时间。以年龄、性别、居住地点、入院前功能性口服摄入量量表、肺炎严重程度和周末入院作为自变量进行多元回归分析。
周末入院组有41例患者,工作日入院组有103例患者。两组的基线特征相似。禁食时间的中位数差异为23.3小时;在多元回归分析中,周末入院组的禁食时间比工作日入院组显著长20.03小时(95%置信区间:2.81-37.25)。
周末住院与吸入性肺炎住院患者较长的禁食时间显著相关。有必要建立一个系统,以便能够让周末入院的患者尽早开始进食。