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Risk factors for aspiration pneumonia in frail older people: a systematic literature review

Claar D van der Maarel-Wierink, Jacques Vanobbergen, Ewald M Bronkhorst, Jos MGA Schols and Cees de Baat (2011) JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION. 12(5). p.344-354
abstract
Objective: To systematically review the risks for aspiration pneumonia in frail older people and the contribution of bad oral health among the risk factors. Design: Systematic literature review. Setting: PubMed (Medline), Web of Science, Cochrane Library, EMBASE, and CINAHL were searched for eligible studies, published in English in the period January 2000 to April 2009. Participants: Frail older people. Measurements: Only publications with regard to hospitalized, institutionalized, or frail home-dwelling people of 60 years and older were eligible. Two authors independently assessed the publications for their methodological quality. Unadjusted and adjusted odds ratios and their corresponding 95% confidence intervals for respective risk factors related to aspiration pneumonia were extracted. The results were evaluated according to the levels of evidence of the Oxford Centre for Evidence-based Medicine. Results: A total of 21 publications fulfilled the quality criteria. Evidence level 2a (systematic review with homogeneity of cohort studies) was found for a positive relationship between aspiration pneumonia and age, male gender, lung diseases, dysphagia, and diabetes mellitus; 2b (individual cohort study) for severe dementia, angiotensin l-converting enzyme deletion/deletion genotype, and bad oral health; 3a (systematic review with homogeneity of case-control studies) for malnutrition; 3b (individual case-control study) for Parkinson's disease and the use of antipsychotic drugs, proton pump inhibitors, and angiotensin-converting enzyme inhibitors. The contribution of bad oral health among the risk factors seems limited. Conclusion: Thirteen significant risk factors were identified: age, male gender, lung diseases, dysphagia, diabetes mellitus, severe dementia, angiotensin l-converting enzyme deletion/deletion genotype, bad oral health, malnutrition, Parkinson's disease, and the use of antipsychotic drugs, proton pump inhibitors, and angiotensin-converting enzyme inhibitors. The contribution of bad oral health seems limited.
Please use this url to cite or link to this publication:
author
organization
year
type
journalArticle (review)
publication status
published
subject
keyword
POPULATION, CARE, ELDERLY-PATIENTS, NOSOCOMIAL PNEUMONIA, OROPHARYNGEAL DYSPHAGIA, ACUTE STROKE, NURSING-HOME, CONVERTING-ENZYME GENE, OBSTRUCTIVE PULMONARY-DISEASE, COMMUNITY-ACQUIRED PNEUMONIA, frailty, oral health care, older people, aspiration pneumonia
journal title
JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION
J. Am. Med. Dir. Assoc.
volume
12
issue
5
pages
344 - 354
Web of Science type
Review
Web of Science id
000292061300006
JCR category
GERIATRICS & GERONTOLOGY
JCR impact factor
4.645 (2011)
JCR rank
4/44 (2011)
JCR quartile
1 (2011)
ISSN
1525-8610
DOI
10.1016/j.jamda.2010.12.099
language
English
UGent publication?
yes
classification
A1
copyright statement
I have transferred the copyright for this publication to the publisher
id
5646264
handle
http://hdl.handle.net/1854/LU-5646264
date created
2014-07-10 09:16:41
date last changed
2016-12-19 15:47:25
@article{5646264,
  abstract     = {Objective: To systematically review the risks for aspiration pneumonia in frail older people and the contribution of bad oral health among the risk factors.
Design: Systematic literature review. 
Setting: PubMed (Medline), Web of Science, Cochrane Library, EMBASE, and CINAHL were searched for eligible studies, published in English in the period January 2000 to April 2009.
Participants: Frail older people. 
Measurements: Only publications with regard to hospitalized, institutionalized, or frail home-dwelling people of 60 years and older were eligible. Two authors independently assessed the publications for their methodological quality. Unadjusted and adjusted odds ratios and their corresponding 95\% confidence intervals for respective risk factors related to aspiration pneumonia were extracted. The results were evaluated according to the levels of evidence of the Oxford Centre for Evidence-based Medicine.
Results: A total of 21 publications fulfilled the quality criteria. Evidence level 2a (systematic review with homogeneity of cohort studies) was found for a positive relationship between aspiration pneumonia and age, male gender, lung diseases, dysphagia, and diabetes mellitus; 2b (individual cohort study) for severe dementia, angiotensin l-converting enzyme deletion/deletion genotype, and bad oral health; 3a (systematic review with homogeneity of case-control studies) for malnutrition; 3b (individual case-control study) for Parkinson's disease and the use of antipsychotic drugs, proton pump inhibitors, and angiotensin-converting enzyme inhibitors. The contribution of bad oral health among the risk factors seems limited.
Conclusion: Thirteen significant risk factors were identified: age, male gender, lung diseases, dysphagia, diabetes mellitus, severe dementia, angiotensin l-converting enzyme deletion/deletion genotype, bad oral health, malnutrition, Parkinson's disease, and the use of antipsychotic drugs, proton pump inhibitors, and angiotensin-converting enzyme inhibitors. The contribution of bad oral health seems limited.},
  author       = {van der Maarel-Wierink, Claar D and Vanobbergen, Jacques and Bronkhorst, Ewald M and Schols, Jos MGA and de Baat, Cees},
  issn         = {1525-8610},
  journal      = {JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION},
  keyword      = {POPULATION,CARE,ELDERLY-PATIENTS,NOSOCOMIAL PNEUMONIA,OROPHARYNGEAL DYSPHAGIA,ACUTE STROKE,NURSING-HOME,CONVERTING-ENZYME GENE,OBSTRUCTIVE PULMONARY-DISEASE,COMMUNITY-ACQUIRED PNEUMONIA,frailty,oral health care,older people,aspiration pneumonia},
  language     = {eng},
  number       = {5},
  pages        = {344--354},
  title        = {Risk factors for aspiration pneumonia in frail older people: a systematic literature review},
  url          = {http://dx.doi.org/10.1016/j.jamda.2010.12.099},
  volume       = {12},
  year         = {2011},
}

Chicago
van der Maarel-Wierink, Claar D, Jacques Vanobbergen, Ewald M Bronkhorst, Jos MGA Schols, and Cees de Baat. 2011. “Risk Factors for Aspiration Pneumonia in Frail Older People: a Systematic Literature Review.” Journal of the American Medical Directors Association 12 (5): 344–354.
APA
van der Maarel-Wierink, C. D., Vanobbergen, J., Bronkhorst, E. M., Schols, J. M., & de Baat, C. (2011). Risk factors for aspiration pneumonia in frail older people: a systematic literature review. JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION, 12(5), 344–354.
Vancouver
1.
van der Maarel-Wierink CD, Vanobbergen J, Bronkhorst EM, Schols JM, de Baat C. Risk factors for aspiration pneumonia in frail older people: a systematic literature review. JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION. 2011;12(5):344–54.
MLA
van der Maarel-Wierink, Claar D, Jacques Vanobbergen, Ewald M Bronkhorst, et al. “Risk Factors for Aspiration Pneumonia in Frail Older People: a Systematic Literature Review.” JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION 12.5 (2011): 344–354. Print.