若林 健一郎 (ワカバヤシ ケンイチロウ)

Wakabayashi, Kenichiro

写真a

所属(所属キャンパス)

医学部 耳鼻咽喉科学教室 (信濃町)

職名

専任講師(有期)

 

論文 【 表示 / 非表示

  • Analysis of clinical outcomes in elderly patients with impaired swallowing function

    Sunata K., Terai H., Seki H., Mitsuhashi M., Kagoshima Y., Nakayama S., Wakabayashi K., Muraoka K., Suzuki Y., Suzuki Y.

    PLoS ONE (PLoS ONE)  15 ( 9 September )  2020年09月

     概要を見る

    Japan is the world's leading aging society, and increasing medical expenses for elderly people is an urgent issue. Since aspiration pneumonia in elderly people with impaired swallowing function is a huge problem in Japan, their expected long-term clinical course should be clarified. Accordingly, we collected data from 991 elderly (≥75 years old) patients whose swallowing function was evaluated by Kitasato Institute Hospital's speech therapists (January 1, 2010 to December 31, 2017). We analyzed the relationship between swallowing function and the subjects' long-term prognosis. To clarify the prognostic factors of patients with dysphagia, we obtained their clinical information (age, gender, activities of daily living, nutritional status, availability of alternative feeding pathways such as percutaneous endoscopic gastrostomy, and cognitive function). We confirmed 372 death cases and stratified the cases into three groups using Fujishima's swallowing ability grade, which is used to predict elderly people's real-world life expectancy. Results showed the median survival days were 331 and 952 days in Groups I (Grades 1-3, n = 308) and II (Grades 4-6, n = 153), respectively, whereas the median survival days for Group III (Grades 7-10, n = 530) could not be calculated. We conducted a multivariate analysis using the Cox proportional hazards model with Group I, which revealed that initial grade and percutaneous endoscopic gastrostomy were significant prognostic factors for the subjects' long-term survival. Nevertheless, further discussion is necessary, particularly to determine advanced care planning regarding indications for alternative feeding pathways in elderly patients with severe dysphagia, since percutaneous endoscopic gastrostomy could significantly prolong their survival.

 

担当授業科目 【 表示 / 非表示

  • 慢性期病態学各論

    2022年度

  • 耳鼻咽喉科学講義

    2022年度

  • 薬物治療学3

    2022年度

  • 慢性期病態学各論

    2021年度