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Progression of swallowing dysfunction and associated complications of dysphagia in a cohort of patients with serial videofluoroscopic swallow examinations

Published online by Cambridge University Press:  10 June 2021

R Hanna
Affiliation:
Department of Medicine, University of Calgary, Calgary, Canada Division of Otolaryngology – Head and Neck Surgery, Department of Surgery, McMaster University, Hamilton, Canada
D R Randall*
Affiliation:
Section of Otolaryngology – Head and Neck Surgery, Department of Surgery, Cumming School of Medicine, University of Calgary, Calgary, Canada Outpatient Dysphagia Clinic, Peter Lougheed Centre, Calgary, Canada
*
Author for correspondence: Dr Derrick R Randall, Section of Otolaryngology – Head and Neck Surgery, Department of Surgery, Cumming School of Medicine, Suite 262–1632, 14th Ave NW, CalgaryT2N 1M7, Canada E-mail: d.randall@ucalgary.ca Fax: +1 403 282 0059

Abstract

Objective

Dysphagia is a common symptom with associated complications ranging from mild discomfort to life-threatening pulmonary compromise. Videofluoroscopic swallow is the ‘gold standard’ evaluation for oropharyngeal dysphagia, but little is known about how patients’ performance changes over time.

Method

This was a retrospective cohort study evaluating dysphagia patients’ clinical course by serial videofluoroscopic swallow study. Univariate analysis followed by multivariate analysis were used to identify correlations between pneumonia outcomes, diet allocation, aetiology and comorbidities.

Results

This study identified 104 patients (53 per cent male) stratified into risk groups by penetration-aspiration scale scores. Mean penetration-aspiration scale worsened over time (p < 0.05), but development of pneumonia was not associated with worsened penetration-aspiration scale score over time (p = 0.57) or severity of dysphagia (p = 0.88).

Conclusion

Our dataset identified a large cohort of patients with oropharyngeal dysphagia and demonstrated mean penetration-aspiration scale tendency to worsen. Identifying prognostic factors associated with worsening radiological findings and applying this to patients at risk of clinical swallowing difficulty is needed.

Type
Main Articles
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

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Footnotes

Dr D R Randall takes responsibility for the integrity of the content of the paper

Presented at the Canadian Society of Otolaryngology–Head and Neck Surgery annual meeting, 1–4 June 2019, Edmonton, Canada.

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