Nursing home-acquired pneumonia, dysphagia and associated diseases in nursing home residents: A retrospective, cross-sectional study

What is already known about the topic?
- Nursing home-acquired pneumonia is the second-most common infection in nursing homes and is associated with high mortality, health complications and multimorbidity.
- Nursing home-acquired pneumonia is associated with dysphagia.
- Nursing home residents do recognize their swallowing problems (subjective dysphagia), but consider their swallowing problems a natural symptom of aging or of their diseases.

BackgroundNursing home-acquired pneumonia (NHAP) is a common infection among nursing home residents. There is also a high prevalence of dysphagia in nursing home residents and they suffer more often from comorbidity and multimorbidity. This puts nursing home residents at higher risk of (mortality from) NHAP. Therefore it is important to gain more insight into the incidence of NHAP and the associated medical conditions in nursing home residents with dysphagia.ObjectiveTo investigate possible associations between NHAP and dysphagia in nursing home residents and to search for a medical risk profile for NHAP.DesignA retrospective cross-sectional study.SettingThree nursing homes in The Netherlands.Participants416 electronic medical files of nursing home residents aged 65 or older living in 3 nursing homes.MethodsData about age, gender, diagnosis of dysphagia and/or pneumonia, medical diagnosis and possible cause of death of the nursing home residents were extracted from electronic medical files.ResultsThe data of 373 electronic medical files were analyzed. A significant difference in the prevalence of dysphagia was found between the nursing homes (p < 0.001). The incidence of NHAP was 5-12% in the participating nursing homes. Statistically significant higher incidence of NHAP was found in residents with dysphagia (p = 0.046). Residents with dysphagia had statistically significantly more diseases compared to residents without dysphagia (p = 0.001). Logistic regression analyses revealed no statistically significant associations between NHAP and the number of diseases and the ICD-10 diseases.ConclusionsDysphagia was found to be a risk factor for NHAP. Awareness of the signs of dysphagia by nurses and other care providers is important for early recognition and management of dysphagia and prevention of NHAP.