Cited by 142Dysphagia Assessment and ManagementVoice and Speech DisordersGastroesophageal reflux and treatments

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A Method to Objectively Assess Swallow Function in Adults With Suspected Aspiration

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Omari, Taher I., Dejaeger, Eddy, van Beckevoort, Dirk, Goeleven, Ann, Davidson, Geoffrey P., Dent, John, Tack, Jan, Rommel, Nathalie·2011·Gastroenterology

DOI 10.1053/j.gastro.2011.02.051

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Abstract

Background & aims Pharyngeal manometry and impedance provide information on swallow function. We developed a new analysis approach for assessment of aspiration risk.Methods We studied 20 patients (30-95 years old) with suspected aspiration who were referred for videofluoroscopy, along with controls (ages 24-47 years). The pharyngeal phase of liquid bolus swallowing was recorded with manometry and impedance. Data from the first swallow of a bolus and subsequent clearing swallows were analyzed. We scored fluoroscopic evidence of aspiration and investigated a range of computationally derived functional variables. Of these, 4 stood out as having high diagnostic value: peak pressure (PeakP), pressure at nadir impedance (PNadImp), time from nadir impedance to peak pressure (TNadImp-PeakP), and the interval of impedance drop in the distal pharynx (flow interval).Results During 54 liquid, first swallows and 40 clearing swallows, aspiration was observed in 35 (13 patients). Compared to those of controls, patient swallows were characterized by a lower PeakP, higher PNadImp, longer flow interval, and shorter TNadImp-PeakP. A Swallow Risk Index (SRI), designed to identify dysfunctions associated with aspiration, was developed from iterative evaluations of variables. The average first swallow SRI correlated with the average aspiration score (r = 0.846, P < .00001 for Spearman Rank Correlation). An average SRI of 15, when used as a cutoff, predicted aspiration during fluoroscopy for this cohort (κ = 1.0).Conclusions Pressure-flow variables derived from automated analysis of combined manometric/impedance measurements provide valuable diagnostic information. When combined into an SRI, these measurements are a robust predictor of aspiration.

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Authors: Omari, T. I., Dejaeger, E., van Beckevoort, D., Goeleven, A., Davidson, G. P., Dent, J., Tack, J., & Rommel, N.
Affiliations: Women's and Children's Health Network (AU)
Universitair Ziekenhuis Leuven (BE)
Royal Adelaide Hospital (AU)
Corresponding author: Omari, Taher I.
ORCID: Omari, Taher I.
Goeleven, Ann
Tack, Jan
Rommel, Nathalie
Venue: Gastroenterology
Publisher: Elsevier BV
Published: 2011-05
Volume: 140
Issue: 5
Pages: 1454-1463
ISSN: 0016-5085 (ISSN-L)
DOI: 10.1053/j.gastro.2011.02.051
OpenAlex: W2061971154
Cited by: 142
References: 21
Citations by year: 2026: 1 · 2025: 4 · 2024: 3 · 2023: 4 · 2022: 7 · 2021: 4 · 2020: 8 · 2019: 14 · 2018: 15 · 2017: 11 · 2016: 11 · 2015: 11 · 2014: 13 · 2013: 12 · 2012: 17
FWCI: 36.74
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Gastroenterology (publishedVersion)
PubMed (publishedVersion)
Adelaide Research & Scholarship (AR&S) (University of Adelaide) (submittedVersion)
Topics: Health Sciences › Health Professions › Speech and Hearing › Dysphagia Assessment and Management
Health Sciences › Health Professions › Speech and Hearing › Voice and Speech Disorders
Health Sciences › Medicine › Gastroenterology › Gastroesophageal reflux and treatments
Keywords: aspiration, dysphagia, pharyngeal manometry, impedance, pharyngeal pressure, pressure-flow study
MeSH terms: Adult, Aged, Aged, 80 and over, Deglutition, Deglutition Disorders, Female, Fluoroscopy, Humans, Male, Manometry, Middle Aged, Pharynx, Pressure, Video Recording, Reproducibility of Results, Young Adult

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A Method to Objectively Assess Swallow Function in Adults With Suspected Aspiration

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