%0 Thesis
%A Giraldo Cadavid, Luis Fernando
%A Insignares, Diego
%A Velasco, Valentina
%A Londoño, Natalia
%A Galvis, Ana María
%A Rengifo, María Leonor
%A Bastidas, Alirio R.
%8 2023-08-08
%U http://hdl.handle.net/10818/59050
%X Background:
Aspiration detected in the fiberoptic endoscopy evaluation of swallowing (FEES) has been
inconsistently associated with pneumonia, with no evidence of the risk of pneumonia from
other alterations in swallowing safety detected in FEES.
Methods:
We performed a dynamic, ambidirectional cohort study of 148 subjects at risk of dysphagia
in a tertiary university hospital to determine the risk of pneumonia due to alterations in the
swallowing safety of FEES. We used multivariate negative binomial regression models to
adjust for potential confounders.
Results:
The incidence density rate (IR) of pneumonia in patients with tracheal aspiration of any
consistency was 26.6/100 people-years (RR 7.25; 95% CI: 3.50 to 14.98; P < 0.001). The IR
was 19.7/100 people-years (RR 7.85; 95% CI: 3.34 to 18.47; P < 0.001) in those with
laryngeal penetration of any consistency and 18.1/100 people-years (RR 6.24; 95% CI: 2.58
to 15.09; P < 0.001) in those with pharyngeal residue of any consistency. When adjusted for
aspiration, the association of residue and penetration with pneumonia disappeared,
suggesting that their risk of pneumonia is dependent on the presence of aspiration and that
only aspiration is independently associated with pneumonia. This increased risk of
pneumonia was significant in uni- and multivariate negative binomial regression models.
Conclusions:
We found an independently increased risk of pneumonia in the presence of aspiration in
FEES. Alterations in the oral and pharyngeal phases of swallowing, without aspiration, did
not increase the risk of pneumonia.
%I Universidad de La Sabana
%T Fiberoptic Endoscopy Evaluation of Swallowing (FEES) Findings Associated with High Pneumonia Risk in a Cohort of Patients at Risk of Dysphagia
%~ Intellectum