Association between dysphagia risk and unplanned hospitalization in older patients receiving home medical care

• Published in: Geriatrics & gerontology international Vol. 19; no. 10; pp. 977 - 981
• Main Authors: Watanabe, Kazuhisa, Umegaki, Hiroyuki, Huang, Chi‐Hsien, Arakawa Martins, Beatriz, Asai, Atsushi, Kanda, Shigeru, Nomura, Hideki, Kuzuya, Masafumi
• Format: Journal Article
• Language: English
• Published: Kyoto, Japan John Wiley & Sons Australia, Ltd 01.10.2019; Blackwell Publishing Ltd
• Subjects: Aged; Aged, 80 and over; Barthel Index; Comorbidity; Deglutition Disorders - epidemiology; Dementia - epidemiology; Dysphagia; dysphagia risk; Dysphagia Severity Scale; Female; Frail Elderly; Frailty Index; Home Care Services; home medical care; Hospitalization; Humans; Japan; Male; Nutrition Assessment; Older people; Risk Factors; Japan; Dysphagia Severity Scale; Frailty Index; dysphagia risk; home medical care; Barthel Index
• ISSN: 1444-1586; 1447-0594
• DOI: 10.1111/ggi.13753

Aim Home medical care for older adults with chronic conditions is becoming an increasing important issue in Japan. We need to support long‐term medical care at home and avoid unplanned hospitalizations, which can adversely affect activities of daily living and quality of life. In this study, we investigated whether swallowing function is a risk for unplanned hospitalization in older patients with functional decline who are receiving home medical care. Methods In the current study, we examined data obtained in the Observational study of Nagoya Elderly with HOme MEdical study (ONEHOME) that investigated the medical health of older adults receiving home medical care services in Nagoya City, Japan. The data analyzed were patients’ age, sex, number of medications, Dysphagia Severity Scale, Charlson Comorbidity Index, Barthel Index, Mini Nutritional Assessment – Short Form, Frailty Index and dementia independent scale. The Dysphagia Severity Scale was categorized into the presence or absence of dysphagia risk. The association between dysphagia risk and days until first hospitalization was investigated by Cox regression analysis. Results In total, 86 out of 178 patients had a hospitalization during the study period of 4 years. Cox regression analysis with adjustment for age, sex, Charlson Comorbidity Index, Barthel Index and Mini Nutritional Assessment – Short Form scores showed that a lower Dysphagia Severity Scale score was significantly associated with unexpected hospitalization. Conclusions Dysphagia risk predicts the first unexpected hospitalization in older individuals receiving home medical care. Patients’ swallowing function is an important factor for estimating prognosis. Geriatr Gerontol Int 2019; 19: 977–981.