Use of Videofluoroscopic Swallowing Study in Patients with Aspiration Pneumonia
2
조회
0
다운로드
7
인용
0
참고문헌
키워드
초록
Objective To 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.Method The 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.Results In 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.Conclusion In 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.
Abstract
Objective To 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.Method The 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.Results In 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.Conclusion In 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.
참고문헌 (26)
- Marik PE, "Aspiration pneumonitis and aspiration pneumonia", N Engl J Med, 344, pp.665~671 (2001)
- Beck-Sague C, "Infectious diseases and death among nursing home residents: results of surveillance in 13 nursing homes", Infect Control Hosp Epidemiol, 15, pp.494~496 (1994)
- Marrie TJ, "Nursing home-acquired pneumonia. A case-control study", J Am Geriatr Soc, 34, pp.697~702 (1986)
- Torres A, "Severe communityacquired pneumonia. Epidemiology and prognostic factors", Am Rev Respir Dis, 144, pp.312~318 (1991)
- Moine P, "Severe community-acquired pneumonia. Etiology, epidemiology, and prognosis factors. French Study Group for Community-Acquired Pneumonia in the intensive Care Unit", Chest, 105, pp.1487~1495 (1994)
- Marrie TJ, "Community-acquired pneumonia requiring hospitalization: 5-year prospective study", Rev Infect Dis, 11, pp.586~599 (1989)
- Reza Shariatzadeh M, "Differences in the features of aspiration pneumonia according to site of acquisition: community or continuing care facility", J Am Geriatr Soc, 54, pp.296~302 (2006)
- Langmore SE, "Predictors of aspiration pneumonia: how important is dysphagia?", Dysphagia, 13, pp.69~81 (1998)
- Marik PE, "Aspiration pneumonia and dysphagia in the elderly", Chest, 124, pp.328~336 (2003)
- Loeb M, "Risk factors for pneumonia and other lower respiratory tract infections in elderly residents of long-term care facilities", Arch Intern Med, 159, pp.2058~2064 (1999)
- Rofes L, "Diagnosis and management of oropharyngeal dysphagia and its nutritional and respiratory complications in the elderly", Gastroenterol Res Pract, 2011, pp.1~13 (2011)
- Seo WH, "Clinical study of aspiration pneumonia in stroke patients", J Korean Acad Rehab Med, 18, pp.52~58 (1994)
- Clave P, "Approaching oropharyngeal dysphagia", Rev Esp Enferm Dig, 96, pp.119~131 (2004)
- Gleeson K, "Quantitative aspiration during sleep in normal subjects", Chest, 111, pp.1266~1272 (1997)
- Huxley EJ, "Pharyngeal aspiration in normal adults and patients with depressed consciousness", Am J Med, 64, pp.564~568 (1978)
- Palmer LB, "Oral clearance and pathogenic oropharyngeal colonization in the elderly", Am J Respir Crit Care Med, 164, pp.464~468 (2001)
- Cabre M, "Prevalence and prognostic implications of dysphagia in elderly patients with pneumonia", Age Ageing, 39, pp.39~45 (2010)
- Chung SG, "The effects of posture and bolus viscosity on swallowing in patients with dysphagia", J Korean Acad Rehab Med, 21, pp.20~29 (1997)
- Nakagawa T, "Silent cerebral infarction: a potential risk for pneumonia in the elderly", J Intern Med, 247, pp.255~259 (2000)
- Caruso C, "Cytokine production pathway in the elderly", Immunol Res, 15, pp.84~90 (1996)
- Miller RA, "The cell biology of aging: immunological models", J Gerontol, 44, pp.4~8 (1989)
- Saltzman RL, "Immunodeficiency of the elderly", Rev Infect Dis, 9, pp.1127~1139 (1987)
- Thoman ML, "The cellular and subcellular bases of immunosenescence", Adv Immunol, 46, pp.221~261 (1989)
- Ekberg O, "Social and psychological burden of dysphagia: its impact on diagnosis and treatment", Dysphagia, 17, pp.139~146 (2002)
- Terre R, "Effectiveness of chin-down posture to prevent tracheal aspiration in dysphagia secondary to acquired brain injury. A videofluoroscopy study", Neurogastroenterol Motil, 24, pp.414~419 (2012)
- Mazzini L, "Percutaneous endoscopic gastrostomy and enteral nutrition in amyotrophic lateral sclerosis", J Neurol, 242, pp.695~698 (1995)