a b s t r a c tBackground: Studies have investigated factors related to aspiration pneumonia (AP) onset in stroke patients. However, no study has examined the influence of swallowing function assessment-based strategies. Purpose: The purpose of this study is to investigate factors related to the onset of AP that differ before and after swallowing function assessment. Methods and subjects: Subjects consisted of 143 patients admitted to acute-stage hospitals within 7 days of stroke onset. We examined the association between AP onset within 1 year after stroke and several parameters. Results: AP incidence was 24.5% overall, 20.3% before swallowing function assessment, and 7.7% after assessment. In patients who developed AP prior to swallowing function assessment, the onset was associated with male gender [odds ratio (OR): 6.206, 95% confidence interval (CI): 1.871-28.937], dysarthria (OR: 5.683, CI: 1.432-38.713), and denture usage (OR: 2.843, CI: 1.011-8.048). In those who developed AP after swallowing function assessment, AP was associated with cerebral atrophy (OR: 4.225, CI: 1.071-16.705), infracted foci in the basal ganglia (OR: 8.914, CI: 1.489-77.776), and Barthel Index (BI) <100 points before admission (OR: 5.404, CI: 1.418-21.482). Conclusions: Onset of AP after stroke was associated with gender, dysarthria, denture usage at before swallowing function assessment and cerebral atrophy, infarcted foci in the basal ganglia, and BI before admission at after swallowing function assessment. It is necessary to pay attention to the fact that factors related to AP differ before and after swallowing function assessment to identify patients at high risk of developing AP after stroke.

No abstract

No abstract

Objectives We sought to develop a method for evaluating dysphagia using videofluorography (VF) by analyzing the time course of changes in pharyngeal wall movement and to assess patients with head-and-neck cancer before and after surgery. Methods The subjects were 14 patients diagnosed with head-and-neck cancer. We obtained VF images before and after surgery and analyzed them with two-dimensional video measurement software. Then, we calculated dysfunction scores based on the remaining or aspiration amount of sample by interpreting the VF images. Results We found dysmotility of the posterior pharyngeal wall in some postoperative cases. Inter-and intrarater reproducibility was high in the evaluation of posterior pharyngeal wall movements. A significant difference was found in the scores between the patients showing dysmotility of the posterior pharyngeal wall and no dysmotility. Conclusions We developed a reproducible method for evaluating movements of the posterior pharyngeal wall during swallowing using VF. This may become a useful tool for objectively evaluating VF data.

No abstract