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Video-fluoroscopic swallowing study scale for predicting aspiration pneumonia in Parkinson’s disease

INTRODUCTION: A number of video-fluoroscopic swallowing study (VFSS) abnormalities have been reported in patients with Parkinson’s disease (PD). However, the most crucial finding of subsequent aspiration pneumonia has not been validated fully. We conducted a retrospective and case-control study to d...

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Autores principales: Tomita, Satoshi, Oeda, Tomoko, Umemura, Atsushi, Kohsaka, Masayuki, Park, Kwiyoung, Yamamoto, Kenji, Sugiyama, Hiroshi, Sawada, Hideyuki
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5991364/
https://www.ncbi.nlm.nih.gov/pubmed/29874285
http://dx.doi.org/10.1371/journal.pone.0197608
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author Tomita, Satoshi
Oeda, Tomoko
Umemura, Atsushi
Kohsaka, Masayuki
Park, Kwiyoung
Yamamoto, Kenji
Sugiyama, Hiroshi
Sawada, Hideyuki
author_facet Tomita, Satoshi
Oeda, Tomoko
Umemura, Atsushi
Kohsaka, Masayuki
Park, Kwiyoung
Yamamoto, Kenji
Sugiyama, Hiroshi
Sawada, Hideyuki
author_sort Tomita, Satoshi
collection PubMed
description INTRODUCTION: A number of video-fluoroscopic swallowing study (VFSS) abnormalities have been reported in patients with Parkinson’s disease (PD). However, the most crucial finding of subsequent aspiration pneumonia has not been validated fully. We conducted a retrospective and case-control study to determine the clinically significant VFSS findings in this population, and to propose a practical scale for predicting aspiration pneumonia in patients with PD. METHODS: We enrolled 184 PD patients who underwent VFSS because of suspected dysphagia. The patients who developed aspiration pneumonia within six months of the VFSS were assigned as cases and the patients without aspiration pneumonia at six months were designated as controls. Logistic regression analysis was performed to determine the prognostic VFSS features based on the data of swallowing 3 mL of jelly, which were used to make a PD VFSS scale (PDVFS). The validity of the new PDVFS was evaluated by ROC analysis. Additionally, we used the survival time analysis to compare time to death between groups, stratified by the PDVFS score. RESULTS: Twenty-five patients developed aspiration pneumonia. Among the previously-proposed VFSS features, mastication, lingual motility prior to transfer, aspiration, and total swallow time were identified as significant prognostic factors. We combined these factors to form the PDVFS. The PDVFS score ranges from 0 to 12, with 12 being the worst. ROC analysis revealed 92% sensitivity and 82% specificity at a cutoff point of 3. The higher PDVFS group showed shorter time-to-death than the lower PDVFS group (log rank P = 0.001). CONCLUSION: Our newly developed VFSS severity scale (based on jelly swallowing) for patients with PD was easy to rate and could predict subsequent aspiration pneumonia and poor prognosis in patients with PD.
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spelling pubmed-59913642018-06-08 Video-fluoroscopic swallowing study scale for predicting aspiration pneumonia in Parkinson’s disease Tomita, Satoshi Oeda, Tomoko Umemura, Atsushi Kohsaka, Masayuki Park, Kwiyoung Yamamoto, Kenji Sugiyama, Hiroshi Sawada, Hideyuki PLoS One Research Article INTRODUCTION: A number of video-fluoroscopic swallowing study (VFSS) abnormalities have been reported in patients with Parkinson’s disease (PD). However, the most crucial finding of subsequent aspiration pneumonia has not been validated fully. We conducted a retrospective and case-control study to determine the clinically significant VFSS findings in this population, and to propose a practical scale for predicting aspiration pneumonia in patients with PD. METHODS: We enrolled 184 PD patients who underwent VFSS because of suspected dysphagia. The patients who developed aspiration pneumonia within six months of the VFSS were assigned as cases and the patients without aspiration pneumonia at six months were designated as controls. Logistic regression analysis was performed to determine the prognostic VFSS features based on the data of swallowing 3 mL of jelly, which were used to make a PD VFSS scale (PDVFS). The validity of the new PDVFS was evaluated by ROC analysis. Additionally, we used the survival time analysis to compare time to death between groups, stratified by the PDVFS score. RESULTS: Twenty-five patients developed aspiration pneumonia. Among the previously-proposed VFSS features, mastication, lingual motility prior to transfer, aspiration, and total swallow time were identified as significant prognostic factors. We combined these factors to form the PDVFS. The PDVFS score ranges from 0 to 12, with 12 being the worst. ROC analysis revealed 92% sensitivity and 82% specificity at a cutoff point of 3. The higher PDVFS group showed shorter time-to-death than the lower PDVFS group (log rank P = 0.001). CONCLUSION: Our newly developed VFSS severity scale (based on jelly swallowing) for patients with PD was easy to rate and could predict subsequent aspiration pneumonia and poor prognosis in patients with PD. Public Library of Science 2018-06-06 /pmc/articles/PMC5991364/ /pubmed/29874285 http://dx.doi.org/10.1371/journal.pone.0197608 Text en © 2018 Tomita et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Tomita, Satoshi
Oeda, Tomoko
Umemura, Atsushi
Kohsaka, Masayuki
Park, Kwiyoung
Yamamoto, Kenji
Sugiyama, Hiroshi
Sawada, Hideyuki
Video-fluoroscopic swallowing study scale for predicting aspiration pneumonia in Parkinson’s disease
title Video-fluoroscopic swallowing study scale for predicting aspiration pneumonia in Parkinson’s disease
title_full Video-fluoroscopic swallowing study scale for predicting aspiration pneumonia in Parkinson’s disease
title_fullStr Video-fluoroscopic swallowing study scale for predicting aspiration pneumonia in Parkinson’s disease
title_full_unstemmed Video-fluoroscopic swallowing study scale for predicting aspiration pneumonia in Parkinson’s disease
title_short Video-fluoroscopic swallowing study scale for predicting aspiration pneumonia in Parkinson’s disease
title_sort video-fluoroscopic swallowing study scale for predicting aspiration pneumonia in parkinson’s disease
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5991364/
https://www.ncbi.nlm.nih.gov/pubmed/29874285
http://dx.doi.org/10.1371/journal.pone.0197608
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