scholarly journals DIGEST Scale Predictis More Quality of Life Than PAS: the Residue Influence on Supracricoid Laryngectomy

Author(s):  
Andressa Silva de Freitas ◽  
Guilherme Maia Zica ◽  
Mariana Salles ◽  
Ana Catarina Alves e Silva ◽  
Thiago Huaytalla Silva ◽  
...  

Abstract Introduction Supracricoid laryngectomy (SCL CHEP) removes ∼ 70% of the larynx, resulting in structural rearrangement and modification of the swallowing mechanism, promoting chronic dysphagia. One of the consequences of this new physiology is the formation of pharyngeal residues that can increase the possibility of aspiration. The formation of residues after SCL CHEP, its functional consequences, and its influence on quality of life (QOL) is still poorly described in the literature. Objective To investigate and compare the association between self-reported QoL and objective assessments of swallowing function in patients undergoing SCL CHEP. Methods A cross-sectional study was performed from 2018 to 2020 in a reference service for head and neck surgery in Brazil. A total of 860 swallowing videofluoroscopy images were evaluated using the Penetration and Aspiration Scale (PAS) and Dynamic Imaging Grade of Swallowing Toxicity (DIGEST). Results In a group of 86 patients, there was a significant relationship between oncological staging and the global (p < 0.001) and total (p = 0.002) QoL domains. There was a negative correlation between the DIGEST scale and the emotional domain of the QoL protocol (p = 0.045). The swallowing function proved to be relevant for QoL. Conclusion The PAS scale did not show any correlation with QoL. The functional performance of swallowing according to the DIGEST scale was coherent with the QOL scores. It is suggested that the residue may be a more relevant aspect for QoL than the aspiration, making DIGEST a promising tool in the assessment of dysphagic patients.

2020 ◽  
Vol 7 (4) ◽  
Author(s):  
Jalal Bakhtiyari ◽  
Hooshang Dadgar ◽  
Marziyeh Maddah ◽  
Raheb Ghorbani ◽  
Faezeh Charkhi ◽  
...  

Background: Oropharyngeal dysphagia is a common problem in stroke survivors. Dysphagia and its complications have negative effects on quality of life in stroke survivors. Objectives: This study aimed to investigate the impacts of dysphagia on quality of life in Iranian stroke survivors and to determine potential relationships between demographic variables and the domains of quality of life. Methods: Sixty stroke survivors (aged 60 - 75 years old) with a diagnosis of dysphagia participated in this cross-sectional study. The swallowing function of patients was evaluated by Mann Assessment Swallowing Ability (MASA). The Persian version of the Dysphagia Handicap Index (DHI) was used to determine the impacts of swallowing disorder on the quality of life. Results: The mean total and SD of DHI was 73.03 ± 10.16. There was no statistically significant relationship between sex; age, time post-onset of stroke, and DHI total score as well as its subscales (P > 0.05), whereas there was a relationship between the functional subscale of the DHI and the level of education (r = 0.27, P = 0.037) and also with severity of dysphagia on the base of MASA scores (r = 0.267, P = 0.039). Besides, the severity of dysphagia was positively correlated with DHI’s total scores (r = 0.312, P = 0.017); this means that the higher the severity of dysphagia, resulting in even greater the DHI total scores, which indicates a further reduction in the patient’s quality of life. Conclusions: Based on the findings of this study, it can be concluded that dysphagia in stroke survivors has negative impacts on the quality of life. The relationship between clinical measures of dysphagia severity and quality of life also indicates that the higher the dysphagia severity the lower the quality of life. Dysphagia’s negative impact on the quality of life does not depend on age and gender.


2018 ◽  
Vol 97 (4-5) ◽  
pp. E31-E35 ◽  
Author(s):  
Giannis Thrasyvoulou ◽  
Petros V. Vlastarakos ◽  
Michael Thrasyvoulou ◽  
Aristides Sismanis

We conducted a cross-sectional study to compare the horizontal and vertical methods used in the surgical closure of the neo-pharynx after total laryngectomy in terms of their effect on swallowing function, swallowing-related quality of life ( QOL), and overall QOL. We also assessed the potential influence of age (≤64 vs. ≥65 yr) and the type of treatment modality (primary, salvage, or total laryngectomy with radiotherapy) on outcomes. Our final study population was made up of 34 patients—31 men and 3 women, aged 49 to 89 years (mean: 66.8)— who had undergone a total laryngectomy. One year after surgery, all patients were asked to complete the M.D. Anderson dysphagia inventory (MDADI), which quantifies swallowing function and swallowing-related QOL, and the University of Washington quality-of-life questionnaire (UW-QOL), which quantifies overall QOL. Of the 34 patients, 16 had undergone a horizontal surgical closure of their neo-pharynx and 18 a vertical closure. According to the MDADI, patients in the horizontal group experienced significantly better swallowing function/QOL; the mean composite MDADI scores were 91.5 in the horizontal group and 68.3 in the vertical group (p = 0.005). We found no significant difference in terms of overall QOL, as the respective mean UW-QOL scores were 81.0 and 80.8 (p = 0.93). The population correlation coefficient was positive in both groups, but more so in the horizontal group (ρhorizontal = 0.876 and ρvertical = 0.676). Neither age nor the type of treatment modality employed influenced swallowing function/QOL (page = 0.10, ptreatment modality = 0.78) or overall QOL (page = 0.08, ptreatment modality = 0.59). We conclude that horizontal closure of the neo-pharynx is superior to vertical closure in terms postoperative swallowing function/QOL but not overall QOL.


2020 ◽  
Vol 33 ◽  
Author(s):  
Maiara Gonçalves dos Santos ◽  
Pricila Damiani ◽  
Ana Carolina Zappe Marcon ◽  
Alessandro Haupenthal ◽  
Núbia Pereira Carelli de Avelar

Abstract Introduction: Knee osteoarthritis (KOA) is a common degenerative disease in older people, causing pain, stiffness and dysfunction. Objective: To determine the influence of KOA on functional performance (FP), quality of life (QoL) and pain in older women. Method: This is a cross-sectional study, in which 50 older women diagnosed with KOA and 51 without KOA participated. Participants were assessed using FP tests: Sit-to-stand (STS); Gait speed test (GST); Timed Up and Go (TUG); 6-minute walk test (6 MWT) and the Berg Balance Scale (BBS). Pain was assessed by the visual analog scale (VAS); quality of life by applying the SF-36; and self-perception of the disease by using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Results: No intergroup statistical differences were found in the BBS (p: 0.42), STS (p: 0.59) and 6MWT (p: 0.97). However, the KOA group showed slower GS (p < 0.00) and longer time in TUG (p < 0.00). They also presented higher pain levels (p < 0.01), worse perceived health status regarding pain, stiffness and physical function (WOMAC) (p < 0.01), as well as worse QoL indices in functional capacity, physical limitations, pain and overall health status (p < 0.010). Conclusion: The results of the study demonstrate that older women with KOA showed a decline in FP, QoL and higher pain levels.


2015 ◽  
pp. 50-58
Author(s):  
Thi Dung Nguyen ◽  
Tam Vo

Background: The patients on hemodialysis have a significantly decreased quality of life. One of many problems which reduce the quality of life and increase the mortality in these patients is osteoporosis and osteoporosis associated fractures. Objectives: To assess the bone density of those on hemodialysis by dual energy X ray absorptiometry and to examine the risk factors of bone density reduction in these patients. Patients and Method: This is a cross-sectional study, including 93 patients on chronic hemodialysis at the department of Hemodialysis at Cho Ray Hospital. Results: Mean bone densities at the region of interest (ROI) neck, trochanter, Ward triangle, intertrochanter and total neck are 0.603 ± 0.105; 0.583 ± 0.121; 0.811 ± 0.166; 0.489 ± 0.146; 0.723 ± 0.138 g/cm2 respectively. The prevalences of osteoporosis at those ROI are 39.8%, 15.1%; 28%; 38.7%; and 26.9% respectively. The prevalences of osteopenia at those ROI are 54.8%; 46.3%; 60.2%; 45.2% and 62.7% respectively. The prevalence of osteopososis in at least one ROI is 52.7% and the prevalence of osteopenia in at least one ROI is 47.3%. There are relations between the bone density at the neck and the gender of the patient and the albuminemia. Bone density at the trochanter is influenced by gender, albuminemia, calcemia and phosphoremia. Bone density at the intertrochanter is affected by the gender. Bone density at the Ward triangle is influenced by age and albuminemia. Total neck bone density is influenced by gender, albuminemia and phosphoremia. Conclusion: Osteoporosis in patients on chronic hemodialysis is an issue that requires our attention. There are many interventionable risk factors of bone density decrease in these patients. Key words: Osteoporosis, DEXA, chronic renal failure, chronic hemodialysis


2019 ◽  
pp. 55-62
Author(s):  
Vuong Diem Khanh Doan ◽  
Ngoc Minh Chau Ho ◽  
Thi Van Ngo ◽  
Thi Bao Nga Phan ◽  
Thi Hong Phan Nguyen

Background: Vietnam is entering the stage of aging population; as a result, the quality of life (QOL) of the elderly is really a matter of concern. There is a great deal of research on the quality of life of the elderly while Vietnam witnesses a lack of research on this topic, especially on how physical and social activities have impact on QOL of the elderly. Objectives: (1) To describe the situation of participation in physical, social activities and QOL of the elderly residing in Truong An Ward, Hue city. (2) To examine the association between physical, social activities and QOL among participants. Methodology: This study used cross-sectional study design. A total sample of 420 people aged 60 and above in Truong An Ward, Hue city were interviewd. The SF36 was used to measure the QOL of participants. Results: Percentage of the elderly taking part in physical activity were 66%. 49% reported having the habit of taking part in social activities. The majority of the elderly get their QOL level in three health fields, namely physical, mental and general health at above average. (56.0, 60.7 and 60.8 respectively). There were significant associations between physical activities, social activities and QOL among participants. Conclusion: The percentage of the elderly taking part in physical and social activities were still low. Besides, QOL of the elderly at the research location was not really high. It’s important to encourage the elderly taking part in physical and social activities to improve their quality of life. Key words: Physical activities, social activities, QOL, the elderly


2020 ◽  
Author(s):  
Yaqun Huang ◽  
Sha Yan ◽  
Hongfu Xie ◽  
Ben Wang ◽  
Zhixiang Zhao ◽  
...  

BACKGROUND Rosacea is a chronic inflammatory dermatosis with facial skin involved, leading to physical and emotional problems, which greatly affected quality of life (QoL) of patients. Dermatology Life Quality Index (DLQI) and willingness to pay (WTP) are well-established instruments assessing the health-related quality of life (HRQoL), while very few studies have been focused on this topic about rosacea in China. OBJECTIVE To investigate HRQoL in Chinese rosacea patients assessed by DLQI and WTP and investigate potential predictors for patients with HRQoL severely affected. METHODS This cross-sectional study was conducted on 973 patients with rosacea. Sociodemographic data, clinical features and DLQI were collected, and WTP was assessed by three standardized items. Multivariable logistic analysis was performed to investigate independent factors influencing QoL. RESULTS 921 questionnaires were accomplished by participants. The mean DLQI score was 11.6 (median 11). Patients were willing to pay an average of $1050.2 or € 896.2 (median $431.4 or € 368.1) for complete cure. 33.3% would like to pay more than 20% of their monthly income to achieve sustainable control. There were positive correlations between WTP with DLQI (P < .05). DLQI could be independently impacted by age (21-30 and 31-40, OR = 3.242 and 3.617, respectively), the occupational requirement of appearance (high, OR = 4.410), disease duration (< 2 years, OR = 1.582), oedema (OR = 1.844) and severity of flushing, burning, stinging and pruritus (severe, OR = 2.003, 1.981, 2.491, 2.249, respectively). There were no significant associations between WTP and most of the clinical factors. CONCLUSIONS The QoL was negatively affected and should not be ignored among rosacea patients in China. Patients aged 21-40y, having occupational requirement of appearance, with the disease duration less than 2 years, and suffering severe flushing and related symptoms were more likely to have severe or very severe limitation of QoL.


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