Tottori J. Clin. Res. 7(2), 179-183, 2016

Prevalence of feeding and swallowing disorders among patients admitted toHospital AYumiko Hashimoto1)*, Masako Nakayama1), Taizo Kaneto2)
1) Department of Nursing, NHO Tottori Medical Center2) Department of Neurology, NHO Tottori Medical Center*Correspondence: hashimoto-yumiko@tottori-iryo.hosp.go.jp
Abstract
Hospital A mainly provides national policy-based medical services for patients with intractableneurological diseases (INMD), children and persons with severe motor and intellectual disabilities (SMID),
psychiatric patients, and individuals requiring recovery and rehabilitation programs. To determine theprevalence of feeding and swallowing disorders among patients admitted to this hospital, we analyzed patient
records regarding the primary disease, age, level of functional oral intake, use of drugs contributing todysphagia, episodes of pneumonia, and other parameters. The majority of the patients included in the analysis
had feeding and swallowing problems and an increased risk of aspiration. Overall, 11% had an episode(s) ofpneumonia, most of which was probably due to aspiration. Pneumonia occurred at a similar rate irrespective of
the mode of feeding, either oral or non-oral intake, and may be more likely to occur during the transition phasefrom alternative nutrition to oral intake. The results suggest that, to avoid aspiration pneumonia, it is necessary
to modify food textures, the posture during eating, and mode of feeding according to the level of oral-motor andswallowing functions of each patient, identify factors that can impair the swallowing function, and monitor therisk of silent aspiration. The majority of patients admitted to the psychiatric ward received drugs that cansuppress the swallowing reflex and, therefore, potentially had an increased risk of choking, indicating the needto fully recognize and address the risk of choking in this patient group. Tottori J. Clin. Res. 7(2), 179-183, 2016
Key Words: feeding and swallowing, dysphagia, Foof Intake Level Scale (FILS), aspiration pneumonia,
functional dysphagia therapy, dysphagia committee
Introduction
The major function of Hospital A is to provide
national policy-based medical services for patientswith INMD, tuberculosis, SMID and psychiatricillnesses, and to provide rehabilitation programs forindividuals requiring recovery. The prevalence offeeding and swallowing disorders among patients
admitted to the hospital was analyzed in relation to
the primary disease, age, level of functional oralintake, use of drugs contributing to dysphagia, andepisodes of pneumonia. This report describes thefindings of the analysis, including an increased riskof aspiration and patient characteristics associatedwith pneumonia, along with several issues identified
in the study.

regarding:(a) age (the percentage of elderly patients aged 65
years or older) and the primary disease;(b) functional oral intake rated based on the Food
Intake Level Scale, ranging from levels (Lvs) 1 to 10,
developed by Fujishima et al.1), and the need forassistance during meals (feeding assistance); and(c) the use of antiepileptics (phenytoin and sodiumvalproate)
andantipsychotics(haloperidol,chlorpromazine, risperidone, and olanzapine), which
are major agents that can reduce the swallowing
reflex, during a period of one month (October 2012).
2) Episodes of pneumonia occurring during a 17month period, between August 1, 2011 andDecember 31, 2012, were analyzed. The analysis
focused on hospital-acquired pneumonia developed
in hospitalized patients, and community-acquired
pneumonia in patients admitted for the treatment ofI. Subjects and Methods
1) All patients receiving inpatient care at Hospital A
on October 15, 2012 (n = 399) were evaluated1