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Do dysphagic patients with an absent pharyngeal swallow have a shorter survival than dysphagic patients with pharyngeal swallow? Prognostic importance of a therapeutic videoradiographic swallowing study (TVSS).

Bülow, Margareta LU ; Olsson, Rolf LU and Ekberg, Olle LU (2005) In Acta Radiologica 46(2). p.126-131
Abstract
Purpose:To study survival in two groups of dysphagic patients - one group unable to elicit the pharyngeal stage of swallow (APS) and another group with pharyngeal swallow (WPS) - and to compare recommendations regarding nutrition and therapeutic strategies based on the therapeutic swallowing study.



Material and Methods: In this retrospective study, the records of dysphagic patients who have undergone a therapeutic videoradiographic swallowing study (TVSS) were reviewed. Forty patients without pharyngeal swallow were matched for age and gender with 40 patients with pharyngeal swallow; altogether 80 patients were included in the study. Survival was registered at 3, 12, and 72 months after the TVSS.



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Purpose:To study survival in two groups of dysphagic patients - one group unable to elicit the pharyngeal stage of swallow (APS) and another group with pharyngeal swallow (WPS) - and to compare recommendations regarding nutrition and therapeutic strategies based on the therapeutic swallowing study.



Material and Methods: In this retrospective study, the records of dysphagic patients who have undergone a therapeutic videoradiographic swallowing study (TVSS) were reviewed. Forty patients without pharyngeal swallow were matched for age and gender with 40 patients with pharyngeal swallow; altogether 80 patients were included in the study. Survival was registered at 3, 12, and 72 months after the TVSS.



Results: In this study, the APS group had a significantly shorter survival time (P = 0.0030) compared to the WPS group when followed-up at 12 months. In the APS group, most patients (37.5% (15/40)) died within the 3 months after TVSS. At 72 months, 62.5% (25/40) of the patients in the APS group had died. In the WPS group, 5% (2/40) had died within 3 months and 47.4% (19/40) after 12 months. At 72 months, 52.5% (21/40) of the patients in the WPS group had died. Regarding nutritional and therapeutic recommendations based on TVSS, 34/40 in the APS group were recommended no oral intake. Eighteen naso-gastric tubes were placed directly after TVSS. The therapeutic strategies recommended were head-positioning, thermal tactile stimulation, and tongue exercises (in 8 patients). In the WPS group, all patients were recommended oral intake. Diet modification was recommended in 29 patients. The therapeutic strategies recommended were head-positioning, thermal tactile stimulation, tongue exercises, supraglottic swallow, and effortful swallow (in 24 patients).



Conclusion: Patients unable to elicit the pharyngeal stage of swallow had a shorter survival time than patients with pharyngeal swallow, probably due to a more severe underlying disease. Tube feeding was more frequent in the APS group. Fewer therapeutic strategies were recommended compared to the WPS group. In the WPS group, diet modification was frequent. Several patients had different therapeutic strategies. At the end of the study, 8/40 patients (20%) in the APS group had recovered and regained the ability to elicit the pharyngeal stage of swallow. All eight had achieved active swallowing rehabilitation. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Absent pharyngeal swallow, dysphagia, survival time, therapeutic videoradiographic swallowing study
in
Acta Radiologica
volume
46
issue
2
pages
126 - 131
publisher
John Wiley & Sons
external identifiers
  • pmid:15902885
  • wos:000228184400002
  • scopus:19844375679
ISSN
1600-0455
DOI
10.1080/02841850510015965
language
English
LU publication?
yes
id
1d33e793-ead0-42d7-b898-a32f16cd15ac (old id 137945)
alternative location
http://journalsonline.tandf.co.uk/openurl.asp?genre=article&issn=0284-1851&volume=46&issue=2&spage=126
date added to LUP
2007-07-16 15:55:29
date last changed
2017-04-09 04:24:10
@article{1d33e793-ead0-42d7-b898-a32f16cd15ac,
  abstract     = {Purpose:To study survival in two groups of dysphagic patients - one group unable to elicit the pharyngeal stage of swallow (APS) and another group with pharyngeal swallow (WPS) - and to compare recommendations regarding nutrition and therapeutic strategies based on the therapeutic swallowing study.<br/><br>
<br/><br>
Material and Methods: In this retrospective study, the records of dysphagic patients who have undergone a therapeutic videoradiographic swallowing study (TVSS) were reviewed. Forty patients without pharyngeal swallow were matched for age and gender with 40 patients with pharyngeal swallow; altogether 80 patients were included in the study. Survival was registered at 3, 12, and 72 months after the TVSS.<br/><br>
<br/><br>
Results: In this study, the APS group had a significantly shorter survival time (P = 0.0030) compared to the WPS group when followed-up at 12 months. In the APS group, most patients (37.5% (15/40)) died within the 3 months after TVSS. At 72 months, 62.5% (25/40) of the patients in the APS group had died. In the WPS group, 5% (2/40) had died within 3 months and 47.4% (19/40) after 12 months. At 72 months, 52.5% (21/40) of the patients in the WPS group had died. Regarding nutritional and therapeutic recommendations based on TVSS, 34/40 in the APS group were recommended no oral intake. Eighteen naso-gastric tubes were placed directly after TVSS. The therapeutic strategies recommended were head-positioning, thermal tactile stimulation, and tongue exercises (in 8 patients). In the WPS group, all patients were recommended oral intake. Diet modification was recommended in 29 patients. The therapeutic strategies recommended were head-positioning, thermal tactile stimulation, tongue exercises, supraglottic swallow, and effortful swallow (in 24 patients).<br/><br>
<br/><br>
Conclusion: Patients unable to elicit the pharyngeal stage of swallow had a shorter survival time than patients with pharyngeal swallow, probably due to a more severe underlying disease. Tube feeding was more frequent in the APS group. Fewer therapeutic strategies were recommended compared to the WPS group. In the WPS group, diet modification was frequent. Several patients had different therapeutic strategies. At the end of the study, 8/40 patients (20%) in the APS group had recovered and regained the ability to elicit the pharyngeal stage of swallow. All eight had achieved active swallowing rehabilitation.},
  author       = {Bülow, Margareta and Olsson, Rolf and Ekberg, Olle},
  issn         = {1600-0455},
  keyword      = {Absent pharyngeal swallow,dysphagia,survival time,therapeutic videoradiographic swallowing study},
  language     = {eng},
  number       = {2},
  pages        = {126--131},
  publisher    = {John Wiley & Sons},
  series       = {Acta Radiologica},
  title        = {Do dysphagic patients with an absent pharyngeal swallow have a shorter survival than dysphagic patients with pharyngeal swallow? Prognostic importance of a therapeutic videoradiographic swallowing study (TVSS).},
  url          = {http://dx.doi.org/10.1080/02841850510015965},
  volume       = {46},
  year         = {2005},
}