Document Detail

Transnasal endoscopic evaluation of swallowing: a bedside technique to evaluate ability to swallow pureed diets in elderly patients with dysphagia.
MedLine Citation:
PMID:  23936875     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Endoscopic evaluation of swallowing (EES) is not commonly used by gastroenterologists to evaluate swallowing in patients with dysphagia.
OBJECTIVE: To use transnasal endoscopy to identify factors predicting successful or failed swallowing of pureed foods in elderly patients with dysphagia.
METHODS: EES of pureed foods was performed by a gastroenterologist using a small-calibre transnasal endoscope. Factors related to successful versus unsuccessful swallowing of pureed foods were analyzed with regard to age, comorbid diseases, swallowing activity, saliva pooling, vallecular residues, pharyngeal residues and airway penetration⁄aspiration. Unsuccessful swallowing was defined in patients who could not eat pureed foods at bedside during hospitalization. Logistic regression analysis was used to identify independent predictors of swallowing of pureed foods.
RESULTS: During a six-year period, 458 consecutive patients (mean age 80 years [range 39 to 97 years]) were considered for the study, including 285 (62%) men. Saliva pooling, vallecular residues, pharyngeal residues and penetration⁄aspiration were found in 240 (52%), 73 (16%), 226 (49%) and 232 patients (51%), respectively. Overall, 247 patients (54%) failed to swallow pureed foods. Multivariate logistic regression analysis demonstrated that the presence of pharyngeal residues (OR 6.0) and saliva pooling (OR 4.6) occurred significantly more frequently in patients who failed to swallow pureed foods.
CONCLUSIONS: Pharyngeal residues and saliva pooling predicted impaired swallowing of pureed foods. Transnasal EES performed by a gastroenterologist provided a unique bedside method of assessing the ability to swallow pureed foods in elderly patients with dysphagia.
Torao Sakamoto; Akira Horiuchi; Yoshiko Nakayama
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Canadian journal of gastroenterology = Journal canadien de gastroenterologie     Volume:  27     ISSN:  1916-7237     ISO Abbreviation:  Can. J. Gastroenterol.     Publication Date:  2013 Aug 
Date Detail:
Created Date:  2013-08-12     Completed Date:  2013-11-05     Revised Date:  2014-08-03    
Medline Journal Info:
Nlm Unique ID:  8807867     Medline TA:  Can J Gastroenterol     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  459-62     Citation Subset:  IM    
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MeSH Terms
Aged, 80 and over
Deglutition / physiology*
Deglutition Disorders / diet therapy,  physiopathology*
Endoscopy / methods*
Epiglottis / physiopathology
Equipment Design
Food, Formulated / classification*
Glottis / physiopathology
Larynx / physiopathology
Middle Aged
Pharynx / physiopathology
Point-of-Care Systems*
Respiratory Aspiration / physiopathology
Retrospective Studies
Saliva / secretion
Speech-Language Pathology
Tongue / physiopathology
Trachea / physiopathology
Video Recording / instrumentation
Vocal Cords / physiopathology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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