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Effect of starting oral intake on weekends on the clinical course of patients with aspiration pneumonia

Authors Kenzaka T, Kumabe A, Kosami K, Ueda Y, Takahashi T, Yamamoto Y, Hayashi Y, Kitao A, Okayama M

Received 6 January 2018

Accepted for publication 22 March 2018

Published 9 May 2018 Volume 2018:13 Pages 895—901

DOI https://doi.org/10.2147/CIA.S161786

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Cristina Weinberg

Peer reviewer comments 3

Editor who approved publication: Dr Richard Walker


Tsuneaki Kenzaka,1,2 Ayako Kumabe,2 Koki Kosami,2 Yuki Ueda,2 Takeshi Takahashi,3 Yuya Yamamoto,4 Yurika Hayashi,4 Akihito Kitao,4 Masanobu Okayama5

1Division of Community Medicine and Career Development, Kobe University Graduate School of Medicine, Kobe, Japan; 2Division of General Medicine, Center for Community Medicine, Jichi Medical University School of Medicine, Shimotsuke, Japan; 3Department of Community and Family Medicine, Yuzawa Community Medical Center, Yuzawa, Japan; 4Department of General Medicine, Toyooka Public Hospital, Toyooka, Japan; 5Division of Community Medicine and Medical Education, Kobe University Graduate School of Medicine, Kobe, Japan

Purpose: The aim of this study was to investigate whether the day of starting oral intake affects the clinical course of patients with aspiration pneumonia.
Patients and methods: We conducted a retrospective cohort study of 392 patients who were hospitalized for aspiration pneumonia but tolerated oral intake. Patients were divided into two groups according to the day of starting oral intake: Monday to Friday (midweek group) and Saturday or Sunday (weekend group). Underlying diseases, severity of pneumonia, time to oral intake, hospital duration, discontinuation of oral intake, and death during hospitalization were compared between the groups. Multivariate analysis was performed using hospital duration and discontinuation of oral intake due to aspiration as the dependent variables.
Results: The cohort comprised 244 men and 148 women with a mean age of 79.3 ± 13.1 years. The weekend (n = 98) and midweek (n = 294) groups exhibited similar age, sex, and underlying diseases. There were no significant differences in pneumonia-related factors, such as CURB-65 score, A-DROP score, extent of shadow on chest radiograph, incidence of bacteremia, and ventilator use. The weekend group exhibited a significantly shorter time to oral intake and hospital duration, as well as a significantly lower incidence of discontinuation of oral intake than the midweek group. Multivariate analysis revealed that starting oral intake on the weekend was independently associated with a lower incidence of discontinuation of oral intake due to aspiration.
Conclusion:
The weekend group exhibited a shorter total hospital duration and a lower incidence of discontinuation of oral intake due to aspiration.

Keywords: discontinuation of oral intake, hospital duration, health economics, weekend

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