J Korean Dysphagia Soc.  2018 Jan;8(1):48-55. 10.0000/jkdps.2018.8.1.48.

Frequency and Characteristics of Videofluoroscopic Swallow Study in Patients with Aspiration Pneumonia

Affiliations
  • 1Department of Rehabilitation Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea. ijsh6679@gmail.com
  • 2Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea.
  • 3Department of Rehabilitation Medicine, Pusan National University School of Medicine, Yangsan, Korea.

Abstract


OBJECTIVE
This study was conducted to identify the frequency of videofluoroscopic swallow study (VFSS) and characteristics of VFSS findings in the patients diagnosed with aspiration pneumonia. METHOD: We retrospectively reviewed the medical records of 2,885 patients who has been diagnosed with aspiration pneumonia either clinically or radiographically. Overall, 811 patients could not be examined because of medical problems. The rest of the subjects were divided into two groups according to the presence of neurologic deficit. The findings of VFSS were scored using the Penetration-Aspiration Scale (PAS) and Pharyngeal Residue Grade (PRG), and data were analyzed based on descriptive statistics, the χ² test, t-test, ANCOVA and logistic regression. RESULT: A total of 1,267 subjects (43.9%) underwent VFSS. Among patients who could be examined, 61.1% were tested. Only 26.7% of subjects without neurologic deficit underwent VFSS, while 56.5% of the subjects in the other group underwent the procedure. The PAS and PRG scores did not differ significantly between groups. About 32.7% of the findings showed silent aspiration (PAS 8), which difficult to detect by bedside screening tests.
CONCLUSION
Subjects with neurologic deficit showed significantly higher test rates than the others. There were no significant differences in VFSS findings between groups. Dysphagia should be evaluated in patients with aspiration pneumonia using precise tools, such as VFSS and fiberoptic endoscopic evaluation of swallowing (FEES), regardless of presence of neurological deficit.

Keyword

Aspiration pneumonia; Dysphagia; Frequency; Videofluoroscopic swallow study; Neurologic deficit
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