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https://hdl.handle.net/2440/66895
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Type: | Journal article |
Title: | A method to objectively assess swallow function in adults with suspected aspiration |
Author: | Omari, T. Dejaeger, E. Van Beckevoort, D. Goeleven, A. Davidson, G. Dent, J. Tack, J. Rommel, N. |
Citation: | Gastroenterology, 2011; 140(5):1454-1463 |
Publisher: | W B Saunders Co |
Issue Date: | 2011 |
ISSN: | 0016-5085 1528-0012 |
Statement of Responsibility: | Taher I. Omari, Eddy Dejaeger, Dirk Van Beckevoort, Ann Goeleven, Geoffrey P. Davidson, John Dent, Jan Tack, and Nathalie Rommel |
Abstract: | <h4>Background & aims</h4>Pharyngeal manometry and impedance provide information on swallow function. We developed a new analysis approach for assessment of aspiration risk.<h4>Methods</h4>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).<h4>Results</h4>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).<h4>Conclusions</h4>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. |
Keywords: | Manometry Impedance Esophagus Clinical Trial Swallowing Defects |
Rights: | Copyright © 2011 AGA Institute. Published by Elsevier Inc. All rights reserved. |
DOI: | 10.1053/j.gastro.2011.02.051 |
Published version: | http://dx.doi.org/10.1053/j.gastro.2011.02.051 |
Appears in Collections: | Aurora harvest Paediatrics publications |
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