Comparison of Videofluoroscopic Swallowing Study in Patients with Stroke-Associated Pneumonia
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Objective: To compare the findings of videofluoroscopic swallowing study (VFSS) in patients with stroke-associated pneumonia (SAP). Methods: Between January 2015 and June 2019, 1245 patients diagnosed with pneumonia underwent VFSS examination. Data were collected through retrospective chart reviews. Depending on the diagnosis, 378 post-stroke patients identified were classified into two groups: 327 non-aspiration pneumonia (non-AP) and 51 aspiration pneumonia (AP). Aspiration pneumonia was diagnosed both clinically and radiologically. VFSS results included 11 items of functional dysphagia scoring (FDS) and 8 points of penetration-aspiration scale (PAS) that analyze the swallowing function by anatomical site. Results: Based on the FDS score, the AP group showed significantly higher values in residue in pyriform sinuses (P= 0.01), as compared to the non-AP group. There was a significant difference in the PAS score between both groups (P=0.001).Conclusion: Based on the FDS results, AP in SAP is associated with residue in piriform sinuses. VFSS tests therefore have the potential to be clinically applied to predict the occurrence of aspiration pneumonia in stroke patients.
Abstract
Objective: To compare the findings of videofluoroscopic swallowing study (VFSS) in patients with stroke-associated pneumonia (SAP). Methods: Between January 2015 and June 2019, 1245 patients diagnosed with pneumonia underwent VFSS examination. Data were collected through retrospective chart reviews. Depending on the diagnosis, 378 post-stroke patients identified were classified into two groups: 327 non-aspiration pneumonia (non-AP) and 51 aspiration pneumonia (AP). Aspiration pneumonia was diagnosed both clinically and radiologically. VFSS results included 11 items of functional dysphagia scoring (FDS) and 8 points of penetration-aspiration scale (PAS) that analyze the swallowing function by anatomical site. Results: Based on the FDS score, the AP group showed significantly higher values in residue in pyriform sinuses (P= 0.01), as compared to the non-AP group. There was a significant difference in the PAS score between both groups (P=0.001).Conclusion: Based on the FDS results, AP in SAP is associated with residue in piriform sinuses. VFSS tests therefore have the potential to be clinically applied to predict the occurrence of aspiration pneumonia in stroke patients.
참고문헌 (23)
- Koennecke HC, "Factors influencing in-hospital mortality and morbidity in patients treated on a stroke unit", Neurology, 77, pp.965~972 (2011)
- Hannawi Y, "Stroke-associated pneumonia : major advances and obstacles", Cerebrovasc Dis, 35, pp.430~443 (2013)
- Teramoto S, "Novel preventive and therapuetic strategy for post-stroke pneumonia", Expert Rev Neurother, 9, pp.1187~1200 (2009)
- Nakagawa T, "Sputum substance P in aspiration pneumonia", Lancet, 345, pp.1447~ (1995)
- Chamorro A, "The immunology of acute stroke", Nat Rev Neurol, 8, pp.401~410 (2012)
- Dirnagl U, "Stroke-induced immunodepression : experimental evidence and clinical relevance", Stroke, 38, pp.770~773 (2007)
- Meisel C, "Central nervous system injury-induced immune deficiency syndrome", Nat Rev Neurosci, 6, pp.775~786 (2005)
- Liesz A, "The spectrum of systemic immune alterations after murine focal ischemia : immunodepression versus immunomodulation", Stroke, 40, pp.2849~2858 (2009)
- Walter U, "Insular stroke is associated with acute sympathetic hyperactivation and immunodepression", Eur J Neurol, 20, pp.153~159 (2013)
- Walter U, "Predictors of pneumonia in acute stroke patients admitted to a neurological intensive care unit", J Neurol, 254, pp.1323~1329 (2007)
- Weimar C, "Complications following acute ischemic stroke", Eur Neurol, 48, pp.133~140 (2002)
- Yu KJ, "Different clinical predictors of aspiration pneumonia in dysphagic stroke patients related to stroke lesion : A STROBE-complaint retrospective study", Medicine(Baltimore), 97, pp.e13968~ (2018)
- Han TR, "Quantifying swallowing function after stroke : A functional dysphagia scale based on videofluoroscopic studies", Arch Phys Med Rehabil, 82, pp.677~682 (2001)
- Myunghoon Moon, "흡인성 폐렴 환자에서의 비디오투시 연하검사의 빈도와 특성", 대한연하장애학회지, 8(1), pp.48~55 (2018), 대한연하장애학회[DOI]
- Rosenbek JC, "A penetration-aspiration scale", Dysphagia, 11, pp.93~98 (1996)
- Hyeju Han, "The Relation Between the Presence of Aspiration or Penetration and the Clinical Indicators of Dysphagia in Poststroke Survivors", Annals of Rehabilitation Medicine, 40(1), pp.88~94 (2016), 대한재활의학회
- Daniels SK, "Dysphagia in stroke : Development of a standard method to examine swallowing recovery", J Rehabil Res Dev, 43, pp.347~356 (2006)
- Mann G, "Swallowing function after stroke : prognosis and prognostic factors at 6 months", Stroke, 30, pp.744~748 (1999)
- Stokely SL, "The Relationship Between Pharyngeal Constriction and Post-swallow Residue", Dysphagia, 30, pp.349~356 (2015)
- Westendorp WF, "Post-stroke infection : a systematic review and meta-analysis", BMC Neurol, 11, pp.110~ (2011)
- Chamorro A, "Infection after acute ischemic stroke : a manifestation of brain-induced immunodepression", Stroke, 38, pp.1097~1103 (2007)
- Ryu WS, "Stroke outcomes are worse with larger leukoaraiosis volumes", Brain, 140, pp.158~170 (2017)
- Hayashi M, "Clinical features and outcomes of aspiration pneumonia compared with non-aspiration pneumonia : a retrospective cohort study", J Infect Chemother, 20, pp.436~442 (2014)