Aspiration in the Fiberoptic Endoscopic Evaluation of Swallowing Associated with an Increased Risk of Mortality in a Cohort of Patients Suspected of Oropharyngeal Dysphagia

Cadavid, Luis Fernando Giraldo; Pantoja, Jaime A.; Forero, Yency; Gutiérrez, Hilda M; Bastidas, Alírio Rodrigo

doi:10.1007/s00455-019-10036-7

Cited by 9 publications

(6 citation statements)

References 34 publications

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“…Older age, lower BMI, severe dysphagia on admission, and aspiration are prognostic for worse PSD, similar to some previous studies (Dubin et al., 2013; Giraldo‐Cadavid et al., 2020; Lee et al., 2020). As the age increases, the strength of contraction of the orofacial muscles decreases and the response to food stimulation becomes sluggish, which affects the coordination of swallowing function.…”

Section: Discussionsupporting

confidence: 89%

Demographic and clinical factors associated with recovery of poststroke dysphagia: A meta‐analysis

et al. 2023

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Background Poststroke dysphagia (PSD) recovery depends on various factors. We aimed to provide evidence concerning predictive variables for the recovery of PSD. Methods PubMed, Embase, Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang Database, VIP database of Chinese periodicals, Chinese biomedical literature service system (SinoMed), and Cochrane Library databases were systematically searched up to September 21, 2022. According to the inclusion criteria, the literature searched in the database was screened. The methodological quality of included studies was assessed using the Newcastle‐Ottawa Scale (NOS). Meta‐analysis was performed to identify the factors prognostic for PSD. Results Twenty‐eight studies were eligible, and pooled analyses were allowed for 12 potential prognostic factors. We identified older age, higher National Institutes of Health Stroke Scale (NIHSS) score, lower activities of daily living (ADL) score, lower body mass index (BMI), severe dysphagia on admission, aspiration, brainstem stroke, severe cognitive impairment, and bilateral hemispheric stroke were negative factors for the recovery of PSD, while early intervention and Modified Rankin Scale (mRS) = 0 before onset were protective factors for the recovery of PSD. There was no significant association between stroke type and prognosis of PSD. Conclusion Prognostic factors of PSD summarized in this meta‐analysis could be useful for developing reasonable treatment plan to better promote recovery of swallowing function after stroke.

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Section: Discussionsupporting

confidence: 89%

Demographic and clinical factors associated with recovery of poststroke dysphagia: A meta‐analysis

et al. 2023

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“…Another instrumental technique for dysphagia assessment is the flexible endoscopic evaluation of swallowing (FEES) that allows a direct visualization of the laryngopharynx, whereas patients are asked to eat different consistencies of food with food coloring [ 98 ]. It is a very useful tool to assess the presence of penetration or aspiration residue in the valleculate and pyriform sinuses, despite it is limited in exploring the oral and esophageal phases of deglutition.…”

Section: Dysphagia In Older Subjectsmentioning

confidence: 99%

“…It is a very useful tool to assess the presence of penetration or aspiration residue in the valleculate and pyriform sinuses, despite it is limited in exploring the oral and esophageal phases of deglutition. Giraldo-Cadavid et al showed that aspiration detected by FEES and an age > 65 years were two independent predictors of mortality in 148 patients with oropharyngeal dysphagia [ 98 ].…”

Section: Dysphagia In Older Subjectsmentioning

confidence: 99%

Sarcopenic Dysphagia, Malnutrition, and Oral Frailty in Elderly: A Comprehensive Review

et al. 2022

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Frailty is a highly prevalent condition in the elderly that has been increasingly considered as a crucial public health issue, due to the strict correlation with a higher risk of fragility fractures, hospitalization, and mortality. Among the age-related diseases, sarcopenia and dysphagia are two common pathological conditions in frail older people and could coexist leading to dehydration and malnutrition in these subjects. “Sarcopenic dysphagia” is a complex condition characterized by deglutition impairment due to the loss of mass and strength of swallowing muscles and might be also related to poor oral health status. Moreover, the aging process is strictly related to poor oral health status due to direct impairment of the immune system and wound healing and physical and cognitive impairment might indirectly influence older people’s ability to carry out adequate oral hygiene. Therefore, poor oral health might affect nutrient intake, leading to malnutrition and, consequently, to frailty. In this scenario, sarcopenia, dysphagia, and oral health are closely linked sharing common pathophysiological pathways, disabling sequelae, and frailty. Thus, the aim of the present comprehensive review is to describe the correlation among sarcopenic dysphagia, malnutrition, and oral frailty, characterizing their phenotypically overlapping features, to propose a comprehensive and effective management of elderly frail subjects.

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“…It can detect the presence of impairments in swallowing efficiency (waste) and safety (protection of the lower airways) 25 . It has been already used in other studies of accuracy 26,27 …”

Section: Methodsmentioning

confidence: 99%

“…25 It has been already used in other studies of accuracy. 26,27 The model of flexible nasofibroscope used for the FEES was developed by PENTAX. The boluses chosen for the analysis were categorised based on the International Dysphagia Diet Standardization Initiative (IDDSI) 28 as level 1 (slightly thick) in three offerings, level 3 (moderately thick) in one offering of 10 mL and level 0 (liquid) free swallowing.…”

Section: Me Thodsmentioning

confidence: 99%

Accuracy of an epidemiological oropharyngeal dysphagia screening for older adults

et al. 2021

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Objective The aim of this study was to determine the accuracy of an epidemiological screening questionnaire for oropharyngeal dysphagia in older people. Background Determining the cut‐off point and the accuracy of the self‐reported epidemiological questionnaire for screening oropharyngeal dysphagia in older adults is important for mass screening, which may estimate the prevalence of oropharyngeal dysphagia. Materials and Methods This was a cross‐sectional diagnostic study with a convenience sample of 70 older adults over 60 years of age of both sexes, aged between 60 and 90 years (mean age 69.2; SD, 7.6). It used a screening questionnaire with nine ordered items response options resulted in a score ranging from 0 to 18. The criterion test was the fiberoptic endoscopic evaluation of swallowing, with analysis of the receiver operating characteristic (ROC), with a 5% significance level. Results Oropharyngeal dysphagia frequency by the criterion test was 73%, with no significant difference between age and sex. The area under the ROC curve was 0.88 (95% confidence interval: 0.79‐0.98) above the cut‐off point 3. This screening questionnaire showed good parameters of sensitivity (80%), specificity (89%), positive predictive value (95%), negative predictive value (63%), positive likelihood ratio (7.64), negative likelihood ratio (0.22) and accuracy (83%). Conclusions This questionnaire may be a satisfactory screening tool for estimating the prevalence of oropharyngeal dysphagia in older adults.

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Aspiration in the Fiberoptic Endoscopic Evaluation of Swallowing Associated with an Increased Risk of Mortality in a Cohort of Patients Suspected of Oropharyngeal Dysphagia

Cited by 9 publications

References 34 publications

Demographic and clinical factors associated with recovery of poststroke dysphagia: A meta‐analysis

Demographic and clinical factors associated with recovery of poststroke dysphagia: A meta‐analysis

Sarcopenic Dysphagia, Malnutrition, and Oral Frailty in Elderly: A Comprehensive Review

Accuracy of an epidemiological oropharyngeal dysphagia screening for older adults

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