Community Acquired Pneumonia in Older Adults
This study will utilize diagnostic imaging to estimate the prevalence of aspiration in older adults with suspected community-acquired bacterial pneumonia (CABP). 150 participants over the age of 60 diagnosed with pneumonia in the University of Wisconsin (UW) Emergency Department will be recruited into this study.
|Condition or Disease||Intervention/Treatment||Phase|
Pneumonia is the most common infectious cause of mortality in older adults. Standard practice for older adults with pneumonia involves hospitalization and antibiotics. However, recent studies suggest that a significant portion of suspected community-acquired bacterial pneumonia (CABP) cases may actually be due to distinct, dysphagia-related aspiration syndromes (e.g. aspiration pneumonia, pneumonitis).
The proposed study will utilize diagnostic imaging to generate a prevalence estimate for aspiration in older adults diagnosed with pneumonia. The following aim will be completed:
Determine the prevalence of aspiration among older adults with pneumonia and rates of recurrent pneumonia in this population.
Arms and Interventions
Participants will be over the age of 65 and diagnosed with pneumonia in the UW Emergency Department.
Diagnostic Test: Videofluoroscopic Swallowing Study
Participants swallow different barium containing liquid and food boluses types that are captured on fluoroscopic imaging in real time.
Diagnostic Test: Nuclear medicine pulmonary aspiration study
Participants will be administered radiotracer (Tc-99m-Sulfur Colloid) orally and static images of the chest will then be obtained at specified intervals over the next 2 hours to determine location of the radiotracer.
Diagnostic Test: TOR-BSST and 3 oz Water Swallow
The research specialist will conduct ten 1 tsp water swallows, one cup sip of water and a 3 ounce water swallow test with the patient. After each swallow, the participant is asked to say "ah" so that their voice quality can be assessed.
Diagnostic Test: Sputum Culture
Patients will have sputum collected during stay
Primary Outcome Measures
- Number of Participants with Aspiration [Any point during follow up within 6 months of index visit]
As defined by imaging studies.
Secondary Outcome Measures
- Recurrent pneumonia [Any point during follow up within 6 months of index visit]
As assessed on medical chart review
60 years of age or older
Patient has pneumonia or is being treated for pneumonia as defined by abnormal chest imaging or receiving antibiotics for a chest infection or the provider thinks the patient has pneumonia or is planning to treat the patient for pneumonia.
Patient is clinically stable and able to safely drink water, per the emergency department provider
Ability to provide consent or the presence of a legally authorized representative (LAR) who can consent on behalf of the patient
Allergy to barium
Contacts and Locations
|1||University of Wisconsin||Madison||Wisconsin||United States||53705|
Sponsors and Collaborators
- University of Wisconsin, Madison
- Principal Investigator: Michael Pulia, MD, MS, University of Wisconsin, Madison
Study Documents (Full-Text)None provided.
- Protocol Version 0.11
- SMPH/EMERG MED