Abstract
Objective
Head and neck cancer (HNC) treatment causes dysphagia, which may lead to aspiration
pneumonia (AP). Thickened fluids are widely used to prevent aspiration in patients
with dysphagia; however, there is little evidence that they can prevent AP. This study
aimed to clarify the differences between restriction of oral intake of fluids (R),
only thickened fluids (TF), and no restriction of fluids (NR) for AP in patients with
dysphagia after HNC treatment.
Methods
We retrospectively studied 654 patients with dysphagia after HNC surgery between 2012
and 2021. Of these, 255 had some restriction of fluids. The development of possible
AP and administration of antibacterial drugs were used as outcomes. Multivariate linear
regression and propensity score matching analyses were performed.
Results
The mean patient age was 64 ± 13, 67 ± 11, and 68 ± 10 years, while the Dynamic Imaging
Grade of Swallowing Toxicity score 3–4 was 2.8%, 27.5, and 53.3%% water in NR, TF,
and R groups, respectively. AP was diagnosed or suspected after starting oral intake
in 37 (9.3%), 11 patients (15.9%), and 45 (17.6%) and antibacterial drugs were administered
in 11 (2.8%), 7 patients (10.1%), and 25 (9.8%) in NR, TF, and R groups, respectively.
R and TF had significant negative impacts on AP.
Conclusions
Fluid restrictions may not reduce the risk of AP or affect the administration of antibacterial
drugs. Medical staff should bear in mind that fluid restrictions do not necessarily
prevent AP in patients with HNC.
Keywords
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Article info
Publication history
Published online: February 11, 2023
Accepted:
January 11,
2023
Received:
September 22,
2022
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2023 Japanese Society of Otorhinolaryngology-Head and Neck Surgery, Inc. Published by Elsevier B.V. All rights reserved.
