Are Oropharyngeal Dysphagia Screening Tests Effective in Preventing Pneumonia?

Okuni, Ikuko; Ebihara, Satoru

doi:10.3390/jcm11020370

Cited by 16 publications

(14 citation statements)

References 49 publications

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“…26 Consequently, efforts should be made to prevent aspiration pneumonia through the early detection of dysphagia and several screening tests for dysphagia have been proven to be effective in predicting pneumonia. 27 Our results show that dysphagia is related to in-hospital death, especially among patients admitted for bacterial pneumonia and chronic obstructive pulmonary disease. Other studies have shown excess mortality in patients with dysphagia associated with rehabilitation, intervertebral disc disorders, heart diseases and cancer.…”

Section: Discussionmentioning

confidence: 60%

“…These analyses show how, independently of the reason for admission, dysphagia is associated with aspiration pneumonia, which is a complication previously related to a worse prognosis and death, even when acquired in the community 26 . Consequently, efforts should be made to prevent aspiration pneumonia through the early detection of dysphagia and several screening tests for dysphagia have been proven to be effective in predicting pneumonia 27 …”

Section: Discussionmentioning

confidence: 97%

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Dysphagia in hospitalized patients: Prevalence, related factors and impact on aspiration pneumonia and mortality

Bosch

Comas

Domingo

et al. 2022

Eur J Clin Investigation

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Background Oropharyngeal dysphagia can be highly concerning in hospitalized patients, increasing morbidity and mortality, making its early identification essential. We aimed to characterize dysphagia and its association with aspiration pneumonia and mortality in a tertiary hospital in Barcelona, Spain. Methods Using data from all hospital discharges during the period 2018–2021, we identified the characteristics of patients with dysphagia and their distribution among hospital departments through the minimum data set, which codifies patients' diagnoses according to the International Classification of Diseases 10th Revision (ICD‐10). We used logistic regression models to assess the association between dysphagia, aspiration pneumonia and mortality. Results Dysphagia was present in 2.4% of all hospital discharges and was more frequent in older patients and in men. The diagnoses most frequently associated with dysphagia were aspiration pneumonia (48.2%) and stroke (14%). Higher prevalence of dysphagia was found in the acute geriatric unit (10.3%), neurology (7.6%) and internal medicine (7.5%) wards. Dysphagia was associated with aspiration pneumonia, aOR = 8.04 (95%CI, 6.31–10.25), and independently increased the odds of death among hospitalized patients, aOR = 1.43 (95%CI, 1.19–1.73). Conclusions We conclude that dysphagia is a prevalent and transversal condition, increasing the risk of mortality in all patients, and efforts should be intensified to increase its early detection and correct management.

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Section: Discussionmentioning

confidence: 60%

Section: Discussionmentioning

confidence: 97%

Dysphagia in hospitalized patients: Prevalence, related factors and impact on aspiration pneumonia and mortality

Bosch

Comas

Domingo

et al. 2022

Eur J Clin Investigation

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“…Oropharyngeal dysphagia can cause substantial life-threatening complications such as aspiration pneumonia and malnutrition that are both associated with an increased morbidity [ 4 , 6 – 8 ], length of hospital stay [ 9 , 10 ], and tube dependency [ 11 , 12 ]. Thus, early identification of dysphagia and its timely management are vital for the reduction of these critical postsurgical sequels both for patient’s health and healthcare system [ 13 , 14 ].…”

Section: Introductionmentioning

confidence: 99%

FraMaDySc: dysphagia screening for patients after surgery for head and neck cancer

Hey

Goeze

Sader

et al. 2023

Eur Arch Otorhinolaryngol

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Purpose Oropharyngeal dysphagia is one of the most common postoperative consequences in head and neck cancer patients. Above all, these patients often suffer from aspiration and limitations of oral intake. However, no reliable dysphagia screening is available for this target group. This study aimed to develop and validate a screening, FraMaDySc, based on a water swallow test (WST) for the identification of postsurgical patients with a risk of aspiration, limitations of oral intake, and, as their derivate, a relevant oropharyngeal dysphagia in general (OD) that constituted the main reference standard. Methods A total of 184 postsurgical head and neck cancer patients were tested with a WST. The patients were, on average, 62 years old and predominantly male (71%). After WST, they underwent Fiberoptic Endoscopic Evaluation of Swallowing (FEES®). FEES® results were dichotomized by Penetration aspiration scale and Functional oral intake scale. Patients with a “fail” result on one of these two scales were classified as having OD. Quality criteria of WST were quantified by means of cross-tabulation with FEES® results. Results OD was found in 65% of patients, aspiration in 44%, limitations of oral intake in 56%. WST delivered a “fail” result in 65% of patients. WST showed sensitivity 91% and specificity 88% for OD. Quality criteria for aspiration (sensitivity 64%, specificity 93%) and limitations of oral intake (sensitivity 80%, specificity 87%) were lower. Conclusion FraMaDySc is a standardized, quick, and valid WST and therefore an excellent screening tool for the identification of OD in postoperative head and neck cancer patients.

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“…In fact, the occurrence of dysphagia is a gradual process, along with the deterioration of cognitive functions, especially in the dementia population [ 16 , 17 ]. Continuous monitoring or frequent dysphagia screening is essential in order to mitigate the risk of choking and aspiration [ 18 ].…”

Section: Introductionmentioning

confidence: 99%

A Comprehensive Assessment Protocol for Swallowing (CAPS): Paving the Way towards Computer-Aided Dysphagia Screening

Lim

Lai

et al. 2023

IJERPH

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Dysphagia is one of the most common problems among older adults, which might lead to aspiration pneumonia and eventual death. It calls for a feasible, reliable, and standardized screening or assessment method to prompt rehabilitation measures and mitigate the risks of dysphagia complications. Computer-aided screening using wearable technology could be the solution to the problem but is not clinically applicable because of the heterogeneity of assessment protocols. The aim of this paper is to formulate and unify a swallowing assessment protocol, named the Comprehensive Assessment Protocol for Swallowing (CAPS), by integrating existing protocols and standards. The protocol consists of two phases: the pre-test phase and the assessment phase. The pre-testing phase involves applying different texture or thickness levels of food/liquid and determining the required bolus volume for the subsequent assessment. The assessment phase involves dry (saliva) swallowing, wet swallowing of different food/liquid consistencies, and non-swallowing (e.g., yawning, coughing, speaking, etc.). The protocol is designed to train the swallowing/non-swallowing event classification that facilitates future long-term continuous monitoring and paves the way towards continuous dysphagia screening.

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Are Oropharyngeal Dysphagia Screening Tests Effective in Preventing Pneumonia?

Cited by 16 publications

References 49 publications

Dysphagia in hospitalized patients: Prevalence, related factors and impact on aspiration pneumonia and mortality

Dysphagia in hospitalized patients: Prevalence, related factors and impact on aspiration pneumonia and mortality

FraMaDySc: dysphagia screening for patients after surgery for head and neck cancer

A Comprehensive Assessment Protocol for Swallowing (CAPS): Paving the Way towards Computer-Aided Dysphagia Screening

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