Assessment of Swallowing Function and Dysphagia: Is the Assessment of Swallowing Function Necessary for the Diagnosis of Aspiration Pneumonia?

2020 ◽  
pp. 49-62
Author(s):  
Yoshihiro Suido ◽  
Shinji Teramoto
Keyword(s):  
Aspiration Pneumonia ◽  
Swallowing Function

Characteristics of Swallowing Function in the Very Elderly and Risk Factors of Aspiration Pneumonia

2020 ◽  
Vol 71 (2) ◽  
pp. 221-221
Author(s):  
T. Karaho ◽  
K. Kawahara ◽  
T. Ebihara ◽  
K. Saito
Keyword(s):  
Risk Factors ◽  
Aspiration Pneumonia ◽  
Very Elderly ◽  
Swallowing Function

scholarly journals Usefulness of the Modified Videofluoroscopic Dysphagia Scale in Evaluating Swallowing Function among Patients with Amyotrophic Lateral Sclerosis and Dysphagia

2021 ◽  
Vol 10 (19) ◽  
pp. 4300
Author(s):  
Byung Joo Lee ◽  
Hyoshin Eo ◽  
Donghwi Park
Keyword(s):  
Amyotrophic Lateral Sclerosis ◽  
Aspiration Pneumonia ◽  
Roc Curve ◽  
Oral Feeding ◽  
Roc Curve Analysis ◽  
Swallowing Function ◽  
Feeding Method ◽  
Long Term Prognosis ◽  
Lateral Sclerosis

Introduction: The videofluoroscopic dysphagia scale (VDS) is used to predict the long-term prognosis of dysphagia among patients with the condition. Previously, a modified version of the VDS (mVDS) was established to overcome the relatively low inter-rater reliability of VDS, and was verified in patients with dysphagia, such as stroke patients. However, the validity of mVDS in patients with amyotrophic lateral sclerosis (ALS) has never been proved. Therefore, in this study, we attempted to seek the validity of the mVDS score in patients with ALS suffering from dysphagia. Method: Data from the videofluoroscopic swallowing study (VFSS) of 34 patients with ALS and dysphagia were retrospectively collected. We investigated the presence of aspiration pneumonia and the selected feeding method based on the VFSS. We also evaluated the correlations between the mVDS and the selected feeding method, and between the mVDS and the presence of aspiration pneumonia. Multivariate logistic regression and receiver operating characteristic (ROC) analyses were performed during the data analysis. Results: In patients with ALS and dysphagia, the mVDS scores were statistically correlated with the selected feeding method (p < 0.05) and the presence of aspiration pneumonia (p < 0.05). In the ROC curve analysis, the area under the ROC curve values for the selected feeding method and the presence of aspiration pneumonia were 0.886 (95% confidence interval (CI), 0.730–0.969; p < 0.0001) and 0.886 (95% CI, 0.730–0.969; p < 0.0001), respectively. Conclusion: The mVDS can be a useful tool for quantifying the severity of dysphagia and interpreting the VFSS findings in patients with ALS and dysphagia. However, further studies involving a more general population of patients with ALS are needed to elucidate a more accurate cut-off value for the allowance of oral feeding and the presence of aspiration pneumonia.

MON-PO423: Predictive Factors for Improvement of Swallowing Function in Patients with Aspiration Pneumonia

2019 ◽  
Vol 38 ◽  
pp. S215
Author(s):  
M. Sato ◽  
Y. Ogawa ◽  
N. Atsushi ◽  
I. Motoaki ◽  
K. Masanori ◽  
...  
Keyword(s):  
Aspiration Pneumonia ◽  
Predictive Factors ◽  
Swallowing Function

scholarly journals Risk of aspiration pneumonia in paediatric patients with dysphagia who were found to have laryngeal penetration on the instrumental swallow evaluation: a systematic review protocol

BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e048422
Author(s):  
Vaishali Adlakha ◽  
Leona Ramos ◽  
Abigail Smith ◽  
Olivia Tsistinas ◽  
Emily Tanner-Smith ◽  
...  
Keyword(s):  
Systematic Review ◽  
Aspiration Pneumonia ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Swallowing Function ◽  
Assessment Development ◽  
Increased Risk ◽  
Laryngeal Penetration ◽  
Risk Of Aspiration ◽  
Tracheal Aspiration

IntroductionDysphagia affects several children in USA and around the globe. Videofluoroscopic Swallow Study (VFSS) and Fiberoptic Endoscopic Evaluation of Swallowing (FEES) are the most objective studies to define swallowing function. The presence of tracheal aspiration during VFSS or FEES in children with dysphagia is associated with an increased risk of aspiration pneumonia. However, the association of laryngeal penetration with aspiration pneumonia remains unclear. This systematic review aims to assess the risk of aspiration pneumonia in children with dysphagia with laryngeal penetration on VFSS/FEES and compare it with children with tracheal aspiration and children with neither tracheal aspiration nor laryngeal penetration.Methods and analysisThis study will be a systematic review and meta-analysis. Systematic electronic searches will be conducted on PubMed, EMBASE, Web of Science, CINHAL, Scopus, Cochrane CENTRAL, LILACS and WHO Global Index Medicus. We will include studies published through 6 October 2021. Primary outcome will be the incidence of aspiration pneumonia. Secondary outcomes will be incidence of hospitalisation, paediatric intensive care unit admission, enteral tube requirement, growth, symptoms improvement and mortality. The Cochrane Risk of Bias In Non-Randomised Studies of Interventions tool will be used to assess the risk of bias. Meta-analysis will be used to pool the studies. We will pool dichotomous outcomes to obtain an odd ratio (OR) and report with 95% CI. Continuous outcomes will be pooled to obtain mean difference and reported with 95% CI. Overall grade of evidence will be assessed using Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria, and findings will be presented in a summary of findings table.Ethics and disseminationThis study is a systematic review without contact with patients. Therefore, IRB approval is not required. Authors consent to publishing this review. Data will be kept for review by editors and peer reviewers. Data will be available to general public on request.PROSPERO registration numberCRD42020222145.

scholarly journals Press needle for the Prevention of Aspiration Pneumonia in Elderly People: Study Protocol for a Randomized Double-Blind Placebo-Controlled trial.

2021 ◽  
Author(s):  
Soichiro Kaneko ◽  
Akiko Kikuchi ◽  
Shin Takayama ◽  
Ryutaro Arita ◽  
Yumika Seki ◽  
...  
Keyword(s):  
Elderly People ◽  
Aspiration Pneumonia ◽  
Primary Outcome ◽  
Controlled Trial ◽  
Lower Limbs ◽  
Secondary Outcome ◽  
Swallowing Function ◽  
Double Blind ◽  
Double Blind Placebo ◽  
Investigation Period

Abstract Background: Pneumonia is the fifth most common cause of death among the Japanese, with 97% of deaths occurring among elderly people aged 65 years or older. The incidence ratio of aspiration pneumonia is high for elderly people. Therefore, prophylaxis is important in geriatric medicine. In our previous studies, we reported that stimulation to the acupoints at ST36 and KI3 of the lower limbs with press needle improved the swallowing function of patients with dysphagia. The improvement of swallowing function may prevent aspiration pneumonia. The aim of this study is to investigate the protective efficacy of using press needle stimulation in the lower limbs for aspiration pneumonia.Methods/design: This is a multi-center, randomized double-blind placebo-controlled trial. A total of 140 patients with cerebrovascular disorder with a history of aspiration pneumonia will be recruited from six centers and randomly assigned to either the real press needle group or the sham press needle group in a 1:1 ratio. The press needle will be replaced twice a week. Treatment will be administered bilaterally at acupoints ST36 and KI3. The primary outcome is the frequency of onset of aspiration pneumonia. The secondary outcome is improvement of the latent time of swallowing reflex (LTSR). The investigation period is of 12-month. The primary outcome will be evaluated throughout the period, and secondary outcomes will be assessed at baseline, 1st month, 6th month, and at the end of the investigation period.Discussion: This study will evaluate the effects of press needle on prevention of aspiration pneumonia and improvement of swallowing function of patients. The results of this study will help support the prophylaxis of aspiration pneumonia.Trial registration: UMIN000023123, registered on July 12th, 2016; https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000026460

scholarly journals Clinical Significance of Oral Care and Oral Management on the Treatment and Prevention of Aspiration Pneumonia in the Elderly: Evidences and Pitfalls

2020 ◽  
pp. 1-5
Author(s):  
Shinji Teramoto ◽  
Shinji Teramoto
Keyword(s):  
Clinical Significance ◽  
Aspiration Pneumonia ◽  
Oral Care ◽  
The Elderly ◽  
Oral Bacteria ◽  
Healthcare Management ◽  
Elderly Persons ◽  
Swallowing Function ◽  
Treatment And Prevention ◽  
Swallowing Rehabilitation

Oral care and oral management are important for preventing aspiration pneumonia (ASP). The main pathology of ASP is microaspiration of oropharyngeal contents during night, swallowing rehabilitation must be necessary for the ASP treatment. However, swallowing rehabilitation cannot totally restore the normal swallowing function. Oral healthcare management should be initiated and continued in parallel with antibiotic treatment of ASP. Oral care helps to prevent aspiration pneumonia by reducing oral bacteria, while oral management helps by improving masticatory and rehabilitating functions. The efficacy of oral care for reducing the incidence of pneumonia has been clearly observed in untreated frail elderly patients, but not in well-cared elderly persons. It has been established that oral care is cyclically significant for the prevention of ASP in the elderly. However, oral problems are not the primary cause of ASP in the elderly. Although there is an amount of evidences of oral care for ASP prevention, there are some controversies of the clinical significance of oral care for ASP treatment.

Videofluoroscopic and Manometric Evaluation of Swallowing Function in Patients with Multiple System Atrophy

2003 ◽  
Vol 112 (7) ◽  
pp. 630-636 ◽  
Author(s):  
Ryuzaburo Higo ◽  
Niro Tayama ◽  
Takaharu Nitou ◽  
Takeshi Watanabe ◽  
Yoshikazu Ugawa
Keyword(s):  
Multiple System Atrophy ◽  
Disease Severity ◽  
Aspiration Pneumonia ◽  
Upper Esophageal Sphincter ◽  
Control Group ◽  
Swallowing Function ◽  
Pneumonia Severity ◽  
Severity Of Disease ◽  
History Of ◽  
Esophageal Sphincter

We investigated swallowing function of 29 patients with multiple system atrophy (MSA) by videofluoroscopy and manometry. Abnormal findings in videofluoroscopy were generally consistent with those in Parkinson's disease. Although findings of videofluoroscopy were not correlated with a history of aspiration pneumonia, severity of disease was significantly correlated with a history of aspiration pneumonia. Oropharyngeal and hypopharyngeal swallowing pressures of the patients were decreased to 73.9 ± 48.4 mm Hg and 85.3 ± 42.9 mm Hg, respectively, both of which were significantly different from the pressures of the control group. Incomplete relaxation of the upper esophageal sphincter was seen in 23.1% of the MSA patients, all of whom had had MSA for more than 5 years. In conclusion, patients with MSA are at risk for aspiration pneumonia as disease severity increases, and the swallowing function of patients with more than 5 years' duration of MSA should be routinely followed up with both videofluoroscopy and manometry.

Awareness of Dysphagia in Hospitalized Patients and Its Impact

2021 ◽  
Author(s):  
Natsuda Aumpan ◽  
Tanisa Patcharatrakul ◽  
Narisorn Lakananurak ◽  
Sutep Gonlachanvit
Keyword(s):  
Aspiration Pneumonia ◽  
Neurological Diseases ◽  
Hospitalized Patients ◽  
Severe Malnutrition ◽  
Admission Diagnosis ◽  
Swallowing Function ◽  
Swallowing Problems ◽  
Patients At Risk ◽  
Primary Physicians

Abstract Background and aims: Acute illness might affect the swallowing function. However, there have been limited studies regarding dysphagia awareness in hospitalized patients, factors associated with dysphagia, and its outcomes. Methods: Consecutive patients in an internal medicine ward whom primary physicians prescribed oral diet were prospectively evaluated their swallowing problems by using a water swallow test (WST) and swallowing disturbance questionnaire (SDQ) within 48 hours after admission. Patients characteristics, nutritional status, readmission, and mortality rates were evaluated and compared between patients with and without impaired swallowing. Results: Among 131 enrolled patients (61 males, mean age 58±21 years), 20 patients (15.3%) had abnormal SDQ and 38 patients (29%) had abnormal WST. 19/20 patients with abnormal SDQ had abnormal WST while 19/38 patients with abnormal WST (50.0%) had abnormal SDQ. Patients with swallowing problems by either abnormal SDQ or WST were significantly older than those without (p<0.05). After adjusting for age, underlying neurological disorders (OR 2.96, 95%CI 1.03-8.47; p=0.04), admission diagnosis of pneumonia (OR 5.29, 95%CI 1.47-19.0, p=0.01), and moderate-to-severe malnutrition (OR 4.14, 95%CI 1.67-10.3, p=0.002) were significantly associated with abnormal WST, while malnutrition (OR 9.88, 95%CI 2.36-41.4; p=0.002) was independently associated with abnormal SDQ. For the follow-up period of 14 months, five patients (26.3%) who had abnormal SDQ/WST had aspiration pneumonia and 2 of them died while one patient with normal SDQ and WST (0.9%) had aspiration pneumonia (p<0.001). Conclusion: Dysphagia is an underrecognized problem in hospitalized patients. This problem was associated with underlying neurological diseases, malnutrition, the current diagnosis, and readmission due to pneumonia. Screening for dysphagia is recommended in hospitalized patients, particularly in patients at risk.

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