Risk factors of aspiration pneumonia related to improper oral hygiene behavior in community dysphagia persons with nasogastric tube feeding

Abstract

Background/purpose: Aspiration pneumonia (AsP) was reported to be closely related to poor oral hygiene. This study aimed to investigate the association between caregivers' oral hygiene behavior with AsP in the community dysphagia persons with nasogastric tube feeding (DPNgTF). Materials and methods: A cross-sectional study was conducted on 128 DPNgTF and their corresponding caregivers. A self-reported structuralized questionnaire was used to measure the oral care behavior of caregivers. All data analyses were performed using the SPSS. The Chi-square was used for comparison of nonparametric data. Fisher's exact test was used when the expected frequency of any cell in the table was less than five. A p value <0.05 was considered statistically significant. Results: Fifty-five DPNgTF had developed AsP (43.0%) and they had statistically significantly halitosis (adjusted OR = 4.46; 95%CI = 2.01–9.93), deposition of oropharyngeal secretion (OR = 4.39; 95%CI = 1.99–9.66), dry mouth (OR = 4.23; 95%CI = 1.81–9.85) and closing mouth and not allow to brush (adjusted OR = 2.83; 95%CI = 1.28–6.27). The poor oral hygiene status of DPNgTF was significantly correlated with the occurrence of AsP. The caregivers' oral care to DPNgTF after getting up (OR = 14.09; 95%CI = 2.92–68.08) and using sponge stick to care (OR = 3.29; 95%CI = 1.26–8.55) were the risk factors of AsP. Conclusion: The implemented oral care after getting up only, using sponge stick has a higher risk compared to the implemented oral care prior to sleeping, using toothbrush. The importance of implementing oral care prior to sleeping by using toothbrush should be reinforced in DPNgTF. Guidelines of oral care and education courses for caregivers during the process in their career training are needed. Keywords: aspiration pneumonia, dysphagia, nasogastric tube feeding, oral hygiene