Impact of Long-Term Enteral Feeding Tubes on Aspiration Pneumonia in a Tertiary Care Centre in Saudi Arabia

Muneerah Albugami; Yasmin Al Twaijri; Habib Bassil; Ulrike Laudon; Abeer Ibrahim; Mohamed El Karouri; Abdulaziz Al Rashed; Abdelazeim Elamin; Ahmed Sabry; Rania Abdelreheem; Abdulwahab Motieb; Ali Al Araj; Reem Hawary; Sawsan Al Balawi

doi:doi:10.11648/j.ajim.20150303.13

Impact of Long-Term Enteral Feeding Tubes on Aspiration Pneumonia in a Tertiary Care Centre in Saudi Arabia

Muneerah Albugami, Yasmin Al Twaijri, Habib Bassil, Ulrike Laudon, Abeer Ibrahim, Mohamed El Karouri, Abdulaziz Al Rashed, Abdelazeim Elamin, Ahmed Sabry, Rania Abdelreheem, Abdulwahab Motieb, Ali Al Araj, Reem Hawary, Sawsan Al Balawi

Published in American Journal of Internal Medicine (Volume 3, Issue 3)

Received: 8 March 2015 Accepted: 19 March 2015 Published: 30 March 2015

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Abstract

It is a retrospective Chart Study. The objectives of the study are (1) to determine the incidence of Aspiration Pneumonia (AP) before and after long term feeding tubes insertion in four types of feeding tubes: percutaneous endoscopic gastrostomy (PEG), percutaneous fluoroscopy gastrostomy (PFG), jejunostomy feeding tube (JFT) and nasogastric tube (NGT) ,(2) to find out associations between the incidence of AP in patient who have feeding tubes and age , gender, rate of feeding (continuous or boluses) ,type of formula of used feeding ,use of thickener during oral feeding , persons deliver feedings and family training how to feed patients. (3) Factors that influenced patients’ outcomes. The findings of the study are: (1) No difference in incidence of AP before and after tube insertion. Feeding tubes have limited medical benefits for AP prevention. (2)Rate of feeding either continuous or bolus increase the frequency of AP. (3)No associations between the incidence of AP and age, gender, type of formula, use of thickener during oral feeding, person deliver feedings and family training about method of feeding. (4) Old age is a poor prognostic factor and HHC follow up is a good prognostic factor for outcome. (5) AP increases a patient's hospital readmission and length of stay in the hospital. There is an urgent need to have alternative strategies to reduce the cost.

Published in	American Journal of Internal Medicine (Volume 3, Issue 3)
DOI	10.11648/j.ajim.20150303.13
Page(s)	95-102
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2015. Published by Science Publishing Group

Keywords

Aspiration Pneumonia, Enteral Feeding Tube, Mortality, Percutaneous Fluoroscopic Gastrostomy, Percutaneous Endoscopic Gastrostomy, Gastrojejunostomy

References

[1]	Marik PE. Aspiration pneumonitis and aspiration pneumonia. N Engl J Med. Mar 1 2001; 344(9):665-71.
[2]	Olivier Leroy, Community-acquired Aspiration Pneumonia in Intensive Care Units. Epidemiological and Prognosis Data. AM J RESPIR CRIT CARE MED 1997; 156:1922–1929.
[3]	Baine WB, Epidemiologic trends in the hospitalization of elderly Medicare patients for pneumonia, 1991–1998. Am J Public Health 2001; 91:1121-3.
[4]	Murphy S, Xu J, Kochanek KD. Deaths: Preliminary Data for 2010. National Vital Statistics Report: Center for Disease Control and Prevention. Jan 11, 2012.
[5]	Cabre M,. Prevalence and prognostic implications of dysphagia in elderly patients with pneumonia. Age Ageing. Jan 2010; 39(1):39-45.
[6]	Marianne Opilla. Aspiration Risk and Enteral Feeding: A Clinical Approach. PRACTICAL GASTROENTEROLOGY • APRIL 2003
[7]	Gray DS, Enteral tube feeding and pneumonia. Am J Ment Retard. 2006 Mar;111(2):113-20
[8]	Salem M. Bazarah, PERCUTANEOUS GASTROSTOMY AND GASTROJEJUNOSTOMY: RADIOLOGICAL AND ENDOSCOPIC APPROACH. Annals of Saudi Medicine, Vol 22, Nos 1 -2, 2002
[9]	Arabi Y, Haddad S, The impact of implementing an enteral tube feeding protocol on caloric and protein delivery in intensive care unit patients. Nutr Clin Pract. 2004 Oct;19(5):523-30
[10]	Hanaa Banjar. Gastrostomy Tube Feeding of Cystic Fibrosis Patients. Bahrain Medical Bulletin, Vol. 26, No. 4, March 2004
[11]	Al Rawas M. Percutaneous Fluoroscopic Guided Gastrostomy 6-Years’ Experience in Jeddah, Saudi Arabia. Qatar Medical Journal, Volume 9, No. 2, Dec 2000, P55-57
[12]	Nakajoh, K. Relation between incidence of pneumonia and protective reflexes in post- stroke patients with oral or tube feeding. J Intern Med. 2000; 247: 39-42.
[13]	Livia Sura, Dysphagia in the elderly: management and nutritional considerations .Clin Interv Aging. 2012; 7: 287–298
[14]	Using rapid-cycle quality improvement methodology to reduce feeding tubes in patients with advanced dementia: before and after study. BMJ. 329(7464):491-494, August 28, 2004.
[15]	Mitchell SL,. A national study of the clinical and organizational determinants of tube-feeding among nursing home residents with advanced cognitive impairment. JAMA. 2003;290
[16]	Beaver MEPercutaneous fluoroscopic gastrostomy tube placement in patients with head and neck cancer. Arch Otolaryngol Head Neck Surg. 1998 Oct;124(10):1141-4
[17]	Finucane TE. Bynum JPW. Use of tube feeding to prevent aspiration pneumonia. Lancet. 1996; 348:1421–142418.Peck A, Cohen CE, Mulvihill MN. Long-term enteral feeding of aged demented nursing home patients. J Am Geriatr Soc 1990; 38:1195-1198.
[18]	Cogen R, Weinryb J. Aspiration pneumonia in nursing home patients fed via gastrostomy tubes. Am JGastroenterol 1989; 84:1509-1512.
[19]	Cogen R,. Complications of jejunostomy tube feeding in nursing facility patients. Am J Gatroenterol 1991;86:1610-1613.
[20]	Dwolatzky T, .A prospective comparison of the use of nasogastric and percutaneous endoscopic gastrostomy tubes for long-term enteral feeding in older people.Department of Geriatric Medicine, Shaare Zedek Medical Center, Jesuralem, Israel. Clin Nutr. 2001 Dec; 20(6):535-40.
[21]	Magne N. Comparison between nasogastric tube feeding and percutaneous fluoroscopic gastrostomy in advanced head and neck cancer patients. Eur Arch Otorhinolaryngol. 2001; 258:89–92.
[22]	Panagiotakis PH,. D-PEJ tube placement Prevents Aspiration Pneumonia in High- Risk Patients. Nutr Clin Pract. 2008; 23(2):172-175.
[23]	Ji Hoon Shin. Updates on Percutaneous Radiologic Gastrostomy/Gastrojejunostomy and Jejunostomy. Gut Liver. 2010 September; 4(Suppl. 1): S25–S31.
[24]	Strong RM. Equal aspiration rates from postpylorus and intragastric-placed small-bore nasoenteric feeding tubes: a randomized, prospective study. JPEN J Parenter Enteral Nutr 1992; 16:59-63.
[25]	Fox KA. Aspiration pneumonia following surgically placed feeding tubes. Am J Surg 1995; 170:564-6.
[26]	Henry M. Taylor. Pneumonia frequencies with different enteral tube feeding access sites. Am J Ment Retard. 2002 May;107(3):175-80
[27]	Kadakia SC. Percutaneous endoscopic gastrostomy or jejunostomy and the incidence of aspiration in 79 patients. Am J Surg. 1992 Aug; 164(2):114-8.
[28]	Marik PE. Gastric versus post-pyloric feeding: a systematic review. Crit Care. 2003;7:R46–R51
[29]	Ukleja A, Sanchez-Fermin M. Gastric versus post-pyloric feeding: relationship to tolerance, pneumonia risk, and successful delivery of enteral nutrition. Curr Gastroenterol Rep. 2007 Aug; 9(4):309-16.
[30]	Gomes CA Jr.Percutaneous endoscopic gastrostomy versus nasogastric tube feeding for adults with swallowing disturbances. Cochrane Database Syst Rev. 2012 Mar 14;3:
[31]	Bonten MJ,. Intermittent enteral feeding: the influence on respiratory and digestive tract colonization in mechanically ventilated intensive-care-unit patients. Am J Respir Crit Care Med 1996; 154:394.
[32]	Steevens EC. Comparison of continuous vs intermittent nasogastric enteral feeding in trauma patients: perceptions and practice. Nutr Clin Pract 2002; 17:118.
[33]	MacLeod JB. Prospective randomized control trial of intermittent versus continuous gastric feeds for critically ill trauma patients. J Trauma 2007; 63:57.
[34]	Letícia Faria Serpa;Effects of continuous versus bolus infusion of enteral nutrition in critical patients. REV. HOSP. CLÍN. FAC. MED. S. PAULO 58(1):9-14, 2003
[35]	Tablan OC. Guidelines for preventing health-care associated pneumonia, 2003: recommendations of CDC and the Healthcare Infection Control Practices Advisory Committee. MMWR Recomm Rep. 2004; 53(RR-3):1-36.
[36]	Vasileios Alivizatos. Feeding Tube-related Complications and Problems in Patients Receiving Long-term Home Enteral Nutrition. Indian J Palliat Care. 2012 Jan-Apr; 18(1): 31–33.
[37]	Yutaka Suzuki, Survival of geriatric patients after percutaneous endoscopic gastrostomy in Japan. World J Gastroenterol. 2010 October 28; 16(40): 5084–5091.
[38]	Concetta Finocchiaro, Percutaneous endoscopic gastrostomy: A long-term follow-up. Nutrition Vol. 13, No. 6, 1997
[39]	Onishi J. [Long-term prognosis and satisfaction after percutaneous endoscopic gastrostomy in a general hospital]. Nihon Ronen Igakkai Zasshi. 2002 Nov; 39(6): 639-42.
[40]	Laura C. Hanson. Physicians' Expectations of Benefit from Tube Feeding. J Palliat Med. 2008 October; 11(8): 1130–1134.
[41]	Grant MD, Rudberg MA, Brody JA. Gastrostomy placement and mortality among hospitalized Medicare beneficiaries. JAMA 1998; 279:1973.
[42]	Finucane TE. Tube feeding in dementia: how incentives undermine health care quality and patient safety. J Am Med Dir Assoc. 2007 May; 8(4):205-8.
[43]	Callahan CM,. Healthcare costs associated with percutaneous endoscopic gastrostomy among older adults in a defined community. J Am Geriatr Soc 49: 1525-1529, 2001.

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APA Style

Muneerah Albugami, Yasmin Al Twaijri, Habib Bassil, Ulrike Laudon, Abeer Ibrahim, et al. (2015). Impact of Long-Term Enteral Feeding Tubes on Aspiration Pneumonia in a Tertiary Care Centre in Saudi Arabia. American Journal of Internal Medicine, 3(3), 95-102. https://doi.org/10.11648/j.ajim.20150303.13

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ACS Style

Muneerah Albugami; Yasmin Al Twaijri; Habib Bassil; Ulrike Laudon; Abeer Ibrahim, et al. Impact of Long-Term Enteral Feeding Tubes on Aspiration Pneumonia in a Tertiary Care Centre in Saudi Arabia. Am. J. Intern. Med. 2015, 3(3), 95-102. doi: 10.11648/j.ajim.20150303.13

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AMA Style

Muneerah Albugami, Yasmin Al Twaijri, Habib Bassil, Ulrike Laudon, Abeer Ibrahim, et al. Impact of Long-Term Enteral Feeding Tubes on Aspiration Pneumonia in a Tertiary Care Centre in Saudi Arabia. Am J Intern Med. 2015;3(3):95-102. doi: 10.11648/j.ajim.20150303.13

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@article{10.11648/j.ajim.20150303.13,
  author = {Muneerah Albugami and Yasmin Al Twaijri and Habib Bassil and Ulrike Laudon and Abeer Ibrahim and Mohamed El Karouri and Abdulaziz Al Rashed and Abdelazeim Elamin and Ahmed Sabry and Rania Abdelreheem and Abdulwahab Motieb and Ali Al Araj and Reem Hawary and Sawsan Al Balawi},
  title = {Impact of Long-Term Enteral Feeding Tubes on Aspiration Pneumonia in a Tertiary Care Centre in Saudi Arabia},
  journal = {American Journal of Internal Medicine},
  volume = {3},
  number = {3},
  pages = {95-102},
  doi = {10.11648/j.ajim.20150303.13},
  url = {https://doi.org/10.11648/j.ajim.20150303.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajim.20150303.13},
  abstract = {It is a retrospective Chart Study. The objectives of the study are (1) to determine the incidence of Aspiration Pneumonia (AP) before and after long term feeding tubes insertion in four types of feeding tubes: percutaneous endoscopic gastrostomy (PEG), percutaneous fluoroscopy gastrostomy (PFG), jejunostomy feeding tube (JFT) and nasogastric tube (NGT) ,(2) to find out associations between the incidence of AP in patient who have feeding tubes and age , gender, rate of feeding (continuous or boluses) ,type of formula of used feeding ,use of thickener during oral feeding , persons deliver feedings and family training how to feed patients. (3) Factors that influenced patients’ outcomes. The findings of the study are: (1) No difference in incidence of AP before and after tube insertion. Feeding tubes have limited medical benefits for AP prevention. (2)Rate of feeding either continuous or bolus increase the frequency of AP. (3)No associations between the incidence of AP and age, gender, type of formula, use of thickener during oral feeding, person deliver feedings and family training about method of feeding. (4) Old age is a poor prognostic factor and HHC follow up is a good prognostic factor for outcome. (5) AP increases a patient's hospital readmission and length of stay in the hospital. There is an urgent need to have alternative strategies to reduce the cost.},
 year = {2015}
}

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TY  - JOUR
T1  - Impact of Long-Term Enteral Feeding Tubes on Aspiration Pneumonia in a Tertiary Care Centre in Saudi Arabia
AU  - Muneerah Albugami
AU  - Yasmin Al Twaijri
AU  - Habib Bassil
AU  - Ulrike Laudon
AU  - Abeer Ibrahim
AU  - Mohamed El Karouri
AU  - Abdulaziz Al Rashed
AU  - Abdelazeim Elamin
AU  - Ahmed Sabry
AU  - Rania Abdelreheem
AU  - Abdulwahab Motieb
AU  - Ali Al Araj
AU  - Reem Hawary
AU  - Sawsan Al Balawi
Y1  - 2015/03/30
PY  - 2015
N1  - https://doi.org/10.11648/j.ajim.20150303.13
DO  - 10.11648/j.ajim.20150303.13
T2  - American Journal of Internal Medicine
JF  - American Journal of Internal Medicine
JO  - American Journal of Internal Medicine
SP  - 95
EP  - 102
PB  - Science Publishing Group
SN  - 2330-4324
UR  - https://doi.org/10.11648/j.ajim.20150303.13
AB  - It is a retrospective Chart Study. The objectives of the study are (1) to determine the incidence of Aspiration Pneumonia (AP) before and after long term feeding tubes insertion in four types of feeding tubes: percutaneous endoscopic gastrostomy (PEG), percutaneous fluoroscopy gastrostomy (PFG), jejunostomy feeding tube (JFT) and nasogastric tube (NGT) ,(2) to find out associations between the incidence of AP in patient who have feeding tubes and age , gender, rate of feeding (continuous or boluses) ,type of formula of used feeding ,use of thickener during oral feeding , persons deliver feedings and family training how to feed patients. (3) Factors that influenced patients’ outcomes. The findings of the study are: (1) No difference in incidence of AP before and after tube insertion. Feeding tubes have limited medical benefits for AP prevention. (2)Rate of feeding either continuous or bolus increase the frequency of AP. (3)No associations between the incidence of AP and age, gender, type of formula, use of thickener during oral feeding, person deliver feedings and family training about method of feeding. (4) Old age is a poor prognostic factor and HHC follow up is a good prognostic factor for outcome. (5) AP increases a patient's hospital readmission and length of stay in the hospital. There is an urgent need to have alternative strategies to reduce the cost.
VL  - 3
IS  - 3
ER  -

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Author Information

Muneerah Albugami

Internal Medicine Department, King Faisal Specialist Hospital and Research Center, Riyadh, KSA
Yasmin Al Twaijri

Research Center, King Faisal Specialist Hospital and Research Center, Riyadh, KSA
Habib Bassil

Internal Medicine Department, King Faisal Specialist Hospital and Research Center, Riyadh, KSA
Ulrike Laudon

Internal Medicine Department, King Faisal Specialist Hospital and Research Center, Riyadh, KSA
Abeer Ibrahim

Internal Medicine Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
Mohamed El Karouri

Internal Medicine Department, King Faisal Specialist Hospital and Research Center, Riyadh, KSA
Abdulaziz Al Rashed

Internal Medicine Department, King Faisal Specialist Hospital and Research Center, Riyadh, KSA
Abdelazeim Elamin

Internal Medicine Department, King Faisal Specialist Hospital and Research Center, Riyadh, KSA
Ahmed Sabry

Internal Medicine Department, King Faisal Specialist Hospital and Research Center, Riyadh, KSA
Rania Abdelreheem

Internal Medicine Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
Abdulwahab Motieb

Internal Medicine Department, King Faisal Specialist Hospital and Research Center, Riyadh, KSA
Ali Al Araj

Internal Medicine Department, King Faisal Specialist Hospital and Research Center, Riyadh, KSA
Reem Hawary

Nutrition Services, King Faisal Specialist Hospital and Research Center, Riyadh, KSA
Sawsan Al Balawi

Nutrition Services, King Faisal Specialist Hospital and Research Center, Riyadh, KSA

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APA Style

Muneerah Albugami, Yasmin Al Twaijri, Habib Bassil, Ulrike Laudon, Abeer Ibrahim, et al. (2015). Impact of Long-Term Enteral Feeding Tubes on Aspiration Pneumonia in a Tertiary Care Centre in Saudi Arabia. American Journal of Internal Medicine, 3(3), 95-102. https://doi.org/10.11648/j.ajim.20150303.13

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ACS Style

Muneerah Albugami; Yasmin Al Twaijri; Habib Bassil; Ulrike Laudon; Abeer Ibrahim, et al. Impact of Long-Term Enteral Feeding Tubes on Aspiration Pneumonia in a Tertiary Care Centre in Saudi Arabia. Am. J. Intern. Med. 2015, 3(3), 95-102. doi: 10.11648/j.ajim.20150303.13

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AMA Style

Muneerah Albugami, Yasmin Al Twaijri, Habib Bassil, Ulrike Laudon, Abeer Ibrahim, et al. Impact of Long-Term Enteral Feeding Tubes on Aspiration Pneumonia in a Tertiary Care Centre in Saudi Arabia. Am J Intern Med. 2015;3(3):95-102. doi: 10.11648/j.ajim.20150303.13

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@article{10.11648/j.ajim.20150303.13,
  author = {Muneerah Albugami and Yasmin Al Twaijri and Habib Bassil and Ulrike Laudon and Abeer Ibrahim and Mohamed El Karouri and Abdulaziz Al Rashed and Abdelazeim Elamin and Ahmed Sabry and Rania Abdelreheem and Abdulwahab Motieb and Ali Al Araj and Reem Hawary and Sawsan Al Balawi},
  title = {Impact of Long-Term Enteral Feeding Tubes on Aspiration Pneumonia in a Tertiary Care Centre in Saudi Arabia},
  journal = {American Journal of Internal Medicine},
  volume = {3},
  number = {3},
  pages = {95-102},
  doi = {10.11648/j.ajim.20150303.13},
  url = {https://doi.org/10.11648/j.ajim.20150303.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajim.20150303.13},
  abstract = {It is a retrospective Chart Study. The objectives of the study are (1) to determine the incidence of Aspiration Pneumonia (AP) before and after long term feeding tubes insertion in four types of feeding tubes: percutaneous endoscopic gastrostomy (PEG), percutaneous fluoroscopy gastrostomy (PFG), jejunostomy feeding tube (JFT) and nasogastric tube (NGT) ,(2) to find out associations between the incidence of AP in patient who have feeding tubes and age , gender, rate of feeding (continuous or boluses) ,type of formula of used feeding ,use of thickener during oral feeding , persons deliver feedings and family training how to feed patients. (3) Factors that influenced patients’ outcomes. The findings of the study are: (1) No difference in incidence of AP before and after tube insertion. Feeding tubes have limited medical benefits for AP prevention. (2)Rate of feeding either continuous or bolus increase the frequency of AP. (3)No associations between the incidence of AP and age, gender, type of formula, use of thickener during oral feeding, person deliver feedings and family training about method of feeding. (4) Old age is a poor prognostic factor and HHC follow up is a good prognostic factor for outcome. (5) AP increases a patient's hospital readmission and length of stay in the hospital. There is an urgent need to have alternative strategies to reduce the cost.},
 year = {2015}
}

Copy | Download

TY  - JOUR
T1  - Impact of Long-Term Enteral Feeding Tubes on Aspiration Pneumonia in a Tertiary Care Centre in Saudi Arabia
AU  - Muneerah Albugami
AU  - Yasmin Al Twaijri
AU  - Habib Bassil
AU  - Ulrike Laudon
AU  - Abeer Ibrahim
AU  - Mohamed El Karouri
AU  - Abdulaziz Al Rashed
AU  - Abdelazeim Elamin
AU  - Ahmed Sabry
AU  - Rania Abdelreheem
AU  - Abdulwahab Motieb
AU  - Ali Al Araj
AU  - Reem Hawary
AU  - Sawsan Al Balawi
Y1  - 2015/03/30
PY  - 2015
N1  - https://doi.org/10.11648/j.ajim.20150303.13
DO  - 10.11648/j.ajim.20150303.13
T2  - American Journal of Internal Medicine
JF  - American Journal of Internal Medicine
JO  - American Journal of Internal Medicine
SP  - 95
EP  - 102
PB  - Science Publishing Group
SN  - 2330-4324
UR  - https://doi.org/10.11648/j.ajim.20150303.13
AB  - It is a retrospective Chart Study. The objectives of the study are (1) to determine the incidence of Aspiration Pneumonia (AP) before and after long term feeding tubes insertion in four types of feeding tubes: percutaneous endoscopic gastrostomy (PEG), percutaneous fluoroscopy gastrostomy (PFG), jejunostomy feeding tube (JFT) and nasogastric tube (NGT) ,(2) to find out associations between the incidence of AP in patient who have feeding tubes and age , gender, rate of feeding (continuous or boluses) ,type of formula of used feeding ,use of thickener during oral feeding , persons deliver feedings and family training how to feed patients. (3) Factors that influenced patients’ outcomes. The findings of the study are: (1) No difference in incidence of AP before and after tube insertion. Feeding tubes have limited medical benefits for AP prevention. (2)Rate of feeding either continuous or bolus increase the frequency of AP. (3)No associations between the incidence of AP and age, gender, type of formula, use of thickener during oral feeding, person deliver feedings and family training about method of feeding. (4) Old age is a poor prognostic factor and HHC follow up is a good prognostic factor for outcome. (5) AP increases a patient's hospital readmission and length of stay in the hospital. There is an urgent need to have alternative strategies to reduce the cost.
VL  - 3
IS  - 3
ER  -

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