Predictors of Aspiration Pneumonia in the Elderly With Swallowing Dysfunction: Videofluoroscopic Swallowing Study

Abstract

Objective To identify the variables of videofluoroscopic swallowing study (VFSS) that are useful for predicting the risk of aspiration pneumonia in elderly patients with dysphagia.Methods A total of 251 patients (aged 65 years or more) were included and divided into a pneumonia group (n=133) and a non-pneumonia group (n=118). The pneumonia group included patients who had been diagnosed with aspiration pneumonia, and individuals in the non-pneumonia group did not have pneumonia but were referred for VFSS. The medical records and results of VFSS were reviewed and compared between the groups retrospectively.Results The pneumonia group exhibited a male preponderance and a higher 8-point Penetration-Aspiration Scale (8PPAS) score. The mean values of 8PPAS score for swallowing thick liquid and rice porridge was significantly higher in the pneumonia group. The pharyngeal delay time (PDT) and pharyngeal transit time (PTT) were significantly longer in the pneumonia group. The amounts of vallecular and pyriform sinus residue were increased in the pneumonia group. The delay in swallowing reflex and the decrease in laryngeal elevation were more frequently observed in the pneumonia group. Among those variables, PDT and PTT were identified as significant predictors of aspiration pneumonia based on logistic regression analysis.Conclusion The present study delineated the findings of VFSS, suggesting an increased risk of aspiration pneumonia in elderly patients with dysphagia. The results demonstrate that prolonged PDT and PTT are significant predictors of aspiration pneumonia.

Correlation Between Articulatory Diadochokinetic Parameters and Dysphagia Parameters in Subacute Stroke Patients

“…A previous study found out that MPT is associated with triggering of pharyngeal swallowing and laryngeal elevation in Parkinson's disease [25]. Another previous study showed that prolonged pharyngeal transit time is a significant predictor of aspiration pneumonia in the elderly [26]. This is consistent with our study results, showing that MPT had a negative correlation with triggering of pharyngeal swallow, delayed pharyngeal transit time, and laryngeal elevation, which are important airway protective mechanism during deglutition.…”

Effects of Carbonated Thickened Drinks on Pharyngeal Swallowing with a Flexible Endoscopic Evaluation of Swallowing in Older Patients with Oropharyngeal Dysphagia

“…Regarding the relationship with other evaluations, a correlation was found between pyriform sinus residue and swallowing reflex initiation in C-Thick. Ko et al [ 25 ] reported that among patients with dysphagia, those with aspiration pneumonia had poor PAS, delayed swallowing reflex, and increased vallecula and pyriform sinus residue. Delayed swallowing reflex increases the risk of residual bolus in the vallecula or pyriform sinus.…”

Tongue pressure during swallowing is an independent risk factor for aspiration pneumonia in middle‐aged and older hospitalized patients: An observational study

“…5 Additionally, this leads to a compromised swallowing function. 6 Collectively, these factors are referred to as oral frailty, as indicated by Tanaka. 7 Oral frailty contributes to increased penetration, aspiration, and pharyngeal residue, 8 ultimately leading to colonization of the oral cavity and subsequent aspiration.…”

“…This condition is characterized by various factors, such as diminished occlusal force owing to the loss of teeth, 4 impaired tongue–lip motor function, reduced tongue pressure, and compromised chewing ability 5 . Additionally, this leads to a compromised swallowing function 6 . Collectively, these factors are referred to as oral frailty, as indicated by Tanaka 7 .…”