Association Between Findings on Videofluoroscopic Swallowing Studies and Pneumonia Onset in Residents of Elderly Care Facilities

Introduction Residents of elderly care facilities are at high risk of aspiration and frequently develop pneumonia. Despite this, swallowing function is often not assessed when pneumonia occurs. We evaluated the association between findings on videofluoroscopic swallowing studies (VFSSs) and the onset of pneumonia among elderly care home residents. Methods This retrospective study included residents admitted to a university-affiliated hospital for VFSSs following an acute illness. Participants were categorized into a pneumonia group (n = 29) and a non‑pneumonia group (n = 27). Six VFSS parameters (propulsion impairment, early pharyngeal entry, delayed laryngeal elevation time (LEDT), epiglottic vallecula residue, pyriform sinus residue, and laryngeal penetration or aspiration) were evaluated using established scoring criteria. Comparisons between groups were performed using the Mann-Whitney U test. Results Laryngeal penetration and aspiration were significantly more frequent in the pneumonia group (P = 0.015). No significant differences were observed between groups for propulsion impairment, early pharyngeal entry, LEDT prolongation, vallecular residue, or pyriform sinus residue. Composite scores for the oral and pharyngeal phases did not differ significantly; however, higher severity tended to occur in the pneumonia group. Conclusion Among the VFSS findings, laryngeal penetration or aspiration was significantly associated with pneumonia onset in residents of elderly care facilities. Considering the multifactorial nature of pneumonia development, swallowing assessment should be integrated with evaluation of oral hygiene, systemic health, cognitive function, and the care environment.