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...
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doaj-9a5f74306e3448a0878e487c9099b7812020-11-24T21:35:15ZengPublic Library of Science (PLoS)PLoS ONE1932-62032018-01-01136e019760810.1371/journal.pone.0197608Video-fluoroscopic swallowing study scale for predicting aspiration pneumonia in Parkinson's disease.Satoshi TomitaTomoko OedaAtsushi UmemuraMasayuki KohsakaKwiyoung ParkKenji YamamotoHiroshi SugiyamaHideyuki SawadaINTRODUCTION: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.http://europepmc.org/articles/PMC5991364?pdf=render |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Satoshi Tomita Tomoko Oeda Atsushi Umemura Masayuki Kohsaka Kwiyoung Park Kenji Yamamoto Hiroshi Sugiyama Hideyuki Sawada |
spellingShingle |
Satoshi Tomita Tomoko Oeda Atsushi Umemura Masayuki Kohsaka Kwiyoung Park Kenji Yamamoto Hiroshi Sugiyama Hideyuki Sawada Video-fluoroscopic swallowing study scale for predicting aspiration pneumonia in Parkinson's disease. PLoS ONE |
author_facet |
Satoshi Tomita Tomoko Oeda Atsushi Umemura Masayuki Kohsaka Kwiyoung Park Kenji Yamamoto Hiroshi Sugiyama Hideyuki Sawada |
author_sort |
Satoshi Tomita |
title |
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_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_sort |
video-fluoroscopic swallowing study scale for predicting aspiration pneumonia in parkinson's disease. |
publisher |
Public Library of Science (PLoS) |
series |
PLoS ONE |
issn |
1932-6203 |
publishDate |
2018-01-01 |
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. |
url |
http://europepmc.org/articles/PMC5991364?pdf=render |
work_keys_str_mv |
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