Increased age is an independent risk factor for radiographic aspiration and laryngeal penetration after thoracotomy for pulmonary resection
| Autor: | K. Eric Sommers, Weiwei Zhu, Vicki Lewis, Melissa Czapla, Joseph Garrett, W. Brent Keeling, Jonathan M. Hernandez |
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| Rok vydání: | 2010 |
| Předmět: |
Male
Pulmonary and Respiratory Medicine Larynx medicine.medical_specialty Time Factors Multivariate analysis Point-of-Care Systems Radiography medicine.medical_treatment Video Recording Pneumonia Aspiration Risk Assessment Swallowing Risk Factors otorhinolaryngologic diseases medicine Humans Thoracotomy Pneumonectomy Aged Lung business.industry Age Factors Middle Aged Deglutition Surgery Logistic Models medicine.anatomical_structure Fluoroscopy Anesthesia Female Pulmonary resection Deglutition Disorders Cardiology and Cardiovascular Medicine business Complication |
| Zdroj: | The Journal of Thoracic and Cardiovascular Surgery. 140:573-577 |
| ISSN: | 0022-5223 |
| Popis: | ObjectivesAspiration is an increasingly recognized complication after thoracotomy for pulmonary resection, but mechanisms of postoperative aspiration are poorly characterized. This study sought to evaluate risk factors to better define postthoracotomy aspiration.MethodsThree hundred twenty-one consecutive patients underwent clinical bedside swallowing evaluations after thoracotomy for pulmonary resection on postoperative day 1. Results of videofluoroscopic swallowing studies were independently reviewed by 2 speech pathologists and were assigned aspiration–penetration scores of either 1 (normal) or greater than 1 (abnormal) based on the worst swallow. Operative, demographic, and outcomes data were abstracted for each patient, and multivariate regression analysis was performed.ResultsSeventy-three (22.7%) patients failed bedside evaluation and proceeded to undergo videofluoroscopic swallowing studies. Forty-four (60.3%) patients had an abnormal videofluoroscopic swallowing study result with a mean aspiration–penetration score of 3.9 ± 0.3. Multivariate analysis showed that older age (68.8 vs 56.2 years, P = .002), prior premature spillage (P = .0006), and vallecular residuals after the swallow (P |
| Databáze: | OpenAIRE |
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