Pilot study of 12-month outcomes of nursing home patients with aspiration on videofluoroscopy
Abstract
The 12-month clinical outcomes of nursing home patients who underwent videofluoroscopic swallowing evaluation was determined. A retrospective review of 40 patients in a teaching nursing home who had videofluoroscopic swallowing studies from 1987 through 1989 was performed. Clinical outcomes measured included feeding tube placement, rehospitalization within 1 year, prolonged nursing home stay (> 6 months), pneumonia, and pneumonia death. It was determined if outcomes were associated with the presence of aspiration on videofluoroscopy and subsequent feeding tube placement. In the 12-month follow-up period, 17 of 40 patients (43%) who underwent videofluoroscopic swallowing evaluation developed pneumonia and 18 of 40 (45%) died. Twenty-two patients demonstrated aspiration on videofluoroscopy. Increased rehospitalization was the only outcome measure that was associated with the presence of aspiration on videofluoroscopy (p < or = 0.05). Of 22 patients with aspiration, 15 had feeding tubes placed. This group had a higher rate of pneumonia (p < or = 0.05) and pneumonia death (p < or = 0.05) compared with the 7 patients with aspiration who did not receive feeding tubes. Patients with nasogastric tubes had a higher death rate (7/9) than patients with gastrostomy tubes (2/8; p < or = 0.05), but similar rates of rehospitalization and pneumonia. Nursing home patients who underwent video-fluoroscopic swallowing evaluation had poor clinical outcomes at 12 months, regardless of their test results.(ABSTRACT TRUNCATED AT 250 WORDS)
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Videofluoroscopy is a relatively poor predictor of aspiration pneumonia.
“Additionally, examination requires the patient be moved to the radiology suite and is a relatively poor predictor of aspiration pneumonia.4,5”
From Classification of high-resolution manometry data according to videofluoroscopic parameters using pattern recognition (2013) · cites this paper as [4]
Videofluoroscopy is traditionally considered the gold standard for evaluating aspiration but requires radiation exposure and is a fairly poor predictor of aspiration pneumonia.
“Videofluoroscopy has traditionally been considered the gold standard for evaluating aspiration, but requires radiation exposure and is a fairly poor predictor of aspiration pneumonia.5,13,14”
From Artificial neural network classification of pharyngeal high‐resolution manometry with impedance data (2013) · cites this paper as [13]
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BackgroundPark, D., Woo, S. B., Lee, D. H., Yu, K. J., Cho, J. Y., Kim, J. M., & Lee, Z. (2017) · Annals of Rehabilitation Medicine · doi:10.5535/arm.2017.41.6.915 · Cited by 14 · see citing works
“However, the previous studies that used VFSS reported significant false-negative results in predicting aspiration pneumonia [5,6].”
ResultIt Is Time to Revamp Approaches to Managing Dysphagia in Nursing Homes
Levenson, S. A., & Walker, V. (2019) · Journal of the American Medical Directors Association · doi:10.1016/j.jamda.2019.06.005 · Cited by 14 · see citing works
Clinical characteristics of dysphagic stroke patients with salivary aspiration
Yu, K. J., & Park, D. (2019) · Medicine · doi:10.1097/md.0000000000014977 · Cited by 13 · see citing works
“Previous studies using VFSS, however, have reported significant false-negative results when predicting aspiration pneumonia.([7,8]) In previous studies, salivary aspiration has been suggested as one of the causes of significant falsenegative results when predicting aspiration pneumonia because it cannot be detected wi…”
ResultHeppner, H. J., Sehlhoff, B., Niklaus, D., Pientka, L., & Thiem, U. (2011) · Zeitschrift für Gerontologie und Geriatrie · doi:10.1007/s00391-011-0184-3 · Cited by 13 · see citing works
Factores pronósticos de la neumonía por aspiración adquirida en la comunidad
Ramos, A., Asensio, Á., Caballos, D., & Mariño, M. J. (2002) · Medicina Clínica · doi:10.1016/s0025-7753(02)73326-5 · Cited by 13 · see citing works
Aspiration Pneumonitis and Pneumonia
Marik, P. E. (2011) · Elsevier eBooks · doi:10.1016/b978-1-4377-1367-1.00059-8 · Cited by 11 · see citing works
ANTIBIOTIC AGENTS IN THE ELDERLY
Stalam, M., & Kaye, D. (2000) · Infectious Disease Clinics of North America · doi:10.1016/s0891-5520(05)70252-x · Cited by 12 · see citing works
Motility Disorders of the Esophagus
Kahrilas, P. J., & Pandolfino, J. E. (2008) · Textbook of Gastroenterology · doi:10.1002/9781444303254.ch31 · Cited by 12 · see citing works
Saeian, K., & Shaker, R. (2000) · Current Treatment Options in Gastroenterology · doi:10.1007/s11938-000-0064-1 · Cited by 11 · see citing works
Troubles de la déglutition de l'adulte. Prise en charge diagnostique et thérapeutique
Guily, J. L. S., Périé, S., Bruel, M., Roubeau, B., Susini, B., & Gaillard, C. (2004) · Encyclopédie médico-chirurgicale. Oto-rhino-laryngologie · doi:10.1016/j.emcorl.2004.10.001 · Cited by 11 · see citing works
Giraldo‐Cadavid, L. F., Pantoja, J. A., Forero, Y., M., H. M. G., & Bastidas, A. (2019) · Dysphagia · doi:10.1007/s00455-019-10036-7 · Cited by 11 · see citing works
“This lack of association found by Croghan and Kidd could be due to the low statistical power related to the small sample size and the short follow-up time of these studies compared to the usual requirements of a mortality outcome.”
BackgroundResultApproach to the problem of pneumonia in long-term care facilities
Muder, R. R. (2000) · Comprehensive Therapy · doi:10.1007/s12019-000-0027-4 · Cited by 11 · see citing works
Castellanos, P. F. (1997) · Annals of Otology Rhinology & Laryngology · doi:10.1177/000348949710600602 · Cited by 11 · see citing works
Pneumonia in the Long-Term Resident
Jamshed, N., Woods, C. J., Desai, S. V., Dhanani, S., & Taler, G. A. (2011) · Clinics in Geriatric Medicine · doi:10.1016/j.cger.2011.01.008 · Cited by 10 · see citing works
Effects of chronic aspirations on breathing pattern and ventilatory drive in vagatomized rats
Ouahchi, Y., Lettelier, C., Bon‐Mardion, N., Marie, J., Tardif, C., & Vérin, É. (2011) · Respiratory Physiology & Neurobiology · doi:10.1016/j.resp.2011.01.013 · Cited by 10 · see citing works
Fast Facts and Concepts #10: Tube Feed or Not Tube Feed?
Hallenbeck, J. L. (2002) · Journal of Palliative Medicine · doi:10.1089/10966210260499104 · Cited by 9 · see citing works
- Authors
- Croghan, J. E., Burke, E. M., Caplan, S., & Denman, S.
- Affiliations
- Johns Hopkins University (US)
- ORCID
- Burke, Elizabeth M.
- Venue
- Dysphagia
- Published
- 1994
- Volume
- 9
- Issue
- 3
- Pages
- 141-146
- ISSN
- 0179-051X (ISSN-L)
- 1432-0460
- OpenAlex
- W1969590176
- Cited by
- 159
- References
- 13
- Citations by year
- 2025: 3 · 2024: 1 · 2023: 1 · 2022: 1 · 2021: 3 · 2020: 5 · 2019: 8 · 2018: 1 · 2017: 3 · 2016: 6 · 2015: 5 · 2014: 8 · 2013: 5 · 2012: 6
- FWCI
- 14.04
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Dysphagia (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (5t32ag000120-25)
- National Institute on Aging (T32-AG-00120)
- Topics
- Health Sciences › Health Professions › Speech and Hearing › Dysphagia Assessment and Management
- Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
- Health Sciences › Health Professions › General Health Professions › Geriatric Care and Nursing Homes
- Keywords
- aspiration, videofluoroscopic swallowing study, nursing home residents, feeding tube placement, nasogastric tube, gastrostomy tube, pneumonia, pneumonia mortality, hospital readmission, clinical outcomes
- MeSH terms
- Aged, Deglutition Disorders, Enteral Nutrition, Female, Fluoroscopy, Humans, Male, Middle Aged, Nursing Homes, Pilot Projects, Pneumonia, Aspiration, Retrospective Studies, Videotape Recording
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