Use of Videofluoroscopic Swallowing Study in Patients with Aspiration Pneumonia

Abstract

ObjectiveTo investigate the clinical characteristics of dysphagic elderly Korean patients diagnosed with aspiration pneumonia as well as to examine the necessity of performing a videofluoroscopic swallowing study (VFSS) in order to confirm the presence of dysphagia in such patients.MethodThe medical records of dysphagic elderly Korean subjects diagnosed with aspiration pneumonia were retrospectively reviewed for demographic and clinical characteristics as well as for VFSS findings.ResultsIn total, medical records of 105 elderly patients (81 men and 24 women) were reviewed in this study. Of the 105 patients, 82.9% (n=87) were admitted via the emergency department, and 41.0% (n=43) were confined to a bed. Eighty percent (n=84) of the 105 patients were diagnosed with brain disorders, and 68.6% (n=72) involved more than one systemic disease, such as diabetes mellitus, cancers, chronic cardiopulmonary disorders, chronic renal disorders, and chronic liver disorders. Only 66.7% (n=70) of the 105 patients underwent VFSS, all of which showed abnormal findings during the oral or pharyngeal phase, or both.ConclusionIn this study, among 105 dysphagic elderly patients with aspiration pneumonia, only 66.7% (n=70) underwent VFSS in order to confirm the presence of dysphagia. As observed in this study, the evaluation of dysphagia is essential in order to consider elderly patients with aspiration pneumonia, particularly in patients with poor functional status, brain disorders, or more than one systemic disease. A greater awareness of dysphagia in the elderly, as well as the diagnostic procedures thereof, particularly VFSS, is needed among medical professionals in Korea.

An irregular pulmonary nodule was confirmed diagnosis of aspiration pneumonia by finding plant cells through rapid on‐site evaluation

“…Some scholars have established some methods to evaluate swallowing and cough reflex, such as swallowing provocation test, WST and videofluoroscopy (11,12). In our case, the WST was suspected to be positive.…”

Predictors for achieving oral intake in older patients with aspiration pneumonia: Videofluoroscopic evaluation of swallowing function

“…Swallowing function was evaluated in all patients using VF, which is the strong point of the present study. Dysphagia has been recognized as an important factor leading to pneumonia in older persons, but few detailed data are available on swallowing function using VF in older patients with pneumonia . Previous studies examining the outcome of achieving oral intake in older patients with pneumonia also lacked the detailed data of swallowing function, and they were likely to use only bedside screening .…”

“…Dysphagia has been recognized as an important factor leading to pneumonia in older persons, 5 but few detailed data are available on swallowing function using VF in older patients with pneumonia. 5,15 Previous studies examining the outcome of achieving oral intake in older patients with pneumonia also lacked the detailed data of swallowing function, and they were likely to use only bedside screening. 6,8 However, it is difficult to detect "silent aspiration," which is aspirated material without any clinical manifestations of aspiration, such as coughing, by a bedside swallow test alone, and clinical swallowing testing was reported to be limited to detect aspiration risk.…”

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

“…However, variables of VFSS that are valuable in estimating the risk of aspiration pneumonia in the elderly with dysphagia are unknown. Only one study investigated the findings of VFSS in patients older than 65 years with aspiration pneumonia, but specific parameters were not analyzed or compared with elderly individuals without aspiration pneumonia [15]. The present study aims to identify the variables of VFSS that are useful for predicting the risk of aspiration pneumonia in elderly patients with dysphagia.…”