Much of the research focuses on risk factors

42]. In clinical terms,'''' aspiration precautions, such as

to prevent aspiration of material boil. When tube fed

patients develop pneumonia, aspiration tube feeding boiled

often assumed that the cause of the problem. Finally, many studies of bacteriology

NIA [43-51]. antibiotics. If the cause of pneumonia and was not found

corrected, it is likely to happen again. One of the problems preventing

found. Much of the research focuses on risk factors

associated with dysphagia or hospital. Although these studies are informative, they are limited

other risk factors. This important step in focusing

pneumonia, and clinical results will be more effective if the areas.

Several studies apply specific procedures

such as swallowing therapy [52-56], but with mixed results re

perhaps because other risk factors were not ad dressed

. In a prospective study, risk factors, which included

dysphagia and feeding status, functional status,

, medical status, and oral / dental status were evaluated for

pitalized, in nursing homes or who were outpatient and

enough healthy. clinics, hospital emergency medical wards, and nursing home

Center VA Medical Center, Ann Arbor, Michigan. Intensive care

were recruited. All patients were men and 60 years and older. stroke and other neurological problems, gastrointestinal tract (GIT) diseases, diabetes,

TPS, chronic obstructive pulmonary disease (COPD) and / or congestive heart failure

(CHF). Most subjects had more than one of these problems

identified as subjects of our control. No subjects were enrolled who

current or a history of head and neck cancer. Complaint oropha-

enrollment in the study. All subjects included in the study con-

sented freely in writing and in accordance with written policies and

cal Center, Ann Arbor. Once consent to participate, each subject was given next >> << tion, three scintigraphy examinations to assess esophageal clearance

boiled material. In addition, about half of the subjects as fiber-optic endoscopic evaluation

swallowing (FEESt), modified with

original version [57] to assess the pharynx and larynx swallowing competence.

These swallowing studies were conducted consent-

chance upon request. A thorough dental examination was performed that

throat cultures, and in-depth interviews covering medical and dental condition

held [58]. Saliva and throat samples were cultured

separately. Medical and functional status information was recorded on

observation of the patient or the medical card. After these initial procedures >> <<, subjects watched a result of pneumonia,

death, or until they could return for further examination. Interview

, dental examination, clinical examination and swallowing

saliva collection were repeated in the year, with X-rays examination

line. If pneumonia is suspected or reported in the medical card diagnostics.

Group consisted of the pulmonologist, Geriatrist and cardiologist.

Three criteria were used in determining diagnosis: al-

evated white blood cell count (12000 or higher), fever (temperature

100 5 F.), and a new infiltrate on chest radiograph cells, with most weight

given radiographic data of a new infiltrate. Patients were con-

considered to have pneumonia only when a consensus was reached in the panel. Patients with new congestive heart failure were excluded, as well as >> << any patient with nonaspiration related pneumonia, such as hematog-

few pneumonia. The results of interest in this study was aspiration pneumonia. Pas

patients were defined as + / pneumonia, according to the consensus reached >> << pneumonia panel. All independent variables were sub-

associated with pneumonia. All variables that achieved ap

# 0. 10 two-dimensional analysis were subjected to multiple logistic regression analyzes

Zion. Four models were developed to find the best predictor

aspiration pneumonia in different categories of subjects. Two model

, dental variables were included as independent variables, and

So, all toothless subjects were excluded from consideration. In >> << other tests, the dependence of feeding was buy strattera online included as a functional variable >> << status in these analyzes, all tube-fed patients ex-

included. Data entry was completed in the fourth dimension database, and

Data analysis was conducted using the statistical package SAS. Definitions and measures. Measures of health were

age, stroke and other neurological diseases, COPD, diabetes, CHF, GI Ras

ease more than one of these diagnoses, the number of diagnoses, the use

any medication, the number of drugs currently smoking, entry (1)

outpatient (2) acute inpatient care, (3) nursing home. fully aware, (2) inattentive, distractable or confused, (3) slack or

70 SE Lanhmor al. : Predictors of Aspiration >> <<