Factors associated with a poor outcome:
(1) older age (based on page 2236 will use > 60 years of age)
(2) pulmonary and esophageal involvement
(3) cancer
Factors associated with a good outcome:
(1) younger age (based on page 2236 will use < 50 years of age)
(2) prompt initiation of treatment after clinical onset
Conditions predisposing a patient to aspiration pneumonia:
(1) esophageal motor involvement
(2) ventilatory insufficiency with an inability to take a maximal inspiration
(3) decreased cough reflex
Recommendations for evaluating the patient:
(1) Look for an underlying cancer, especially if there are risk factors.
(2) Monitor esophageal motility.
(3) Monitor pulmonary function, looking for a restrictive pattern or decreased maximal inspiratory ability..
(4) Take steps to prevent aspiration pneumonia.
(5) Monitor the chest X-ray.
