Category: Clinical Practice (assessment, diagnosis, treatment, knowledge translation/EBP, implementation science, program development); Cross-Cutting
We aimed to identify significant risk factors associated with aspiration pneumonia in patients with suspected dysphagia who were evaluated with VFSS.
Design : We retrospectively reviewed the medical records of a series of subjects with dysphagia who underwent videofluoroscopic study(VFSS) from September 2014 to September 2017.
University affiliated hospital.
Participants (or Animals, Specimens, Cadavers) :
A total of consecutive 747 patients who underwent VFSS were enrolled. Patients were divided into groups with and without aspiration pneumonia.
Interventions : Interventions: Not applicable.
Main Outcome Measure(s) : VFSS parameters
The mean age of the enrolled patients was 70.98+13.57 years. Of these, 84 were diagnosed with aspiration pneumonia. There were no group differences according to underlying neurological conditions. Patients with pneumonia were significantly older than those without pneumonia(p=0.03). Among male patients, a significantly larger proportion had aspiration pneumonia(p = 0.04). Within the parameters of initial VFSS, positive aspiration findings with a 1-cc or 2-cc trial irrespective of consistency showed significant differences between the two groups(p<0.001, p=0.013 respectively), while the findings of aspiration with 5 cc, penetration, or remnant of bolus showed no significant differences. Multiple logistic regression analysis showed that the findings of aspiration with a 1-cc trial in VFSS was the best predictor of aspiration pneumonia (odds ratio=4.96; 95% confidence interval, 1.98–12.43; p=0.001).(p
The finding of aspiration with a small bolus in VFSS is the best predictor of aspiration pneumonia, while other parameters failed to reveal a significant effect. The results highlight the importance of detecting small amounts of aspiration on routine VFSS.