Oliveira D L, Moreira E A M, de Freitas M B, Gonçalves J de A, Furkim A M, Clavé P
Emilia Addison Machado Moreira, Departamento de Nutrição, Universidade Federal de Santa Catarina UFSC. Campus Universitário, Trindade, s/n, Florianópolis, Santa Catarina, Brazil. Zip Code: 88.040-970. Phone: +55 48 37219784, Fax: +55 48 37219542, E-mail address:
J Nutr Health Aging. 2017;21(3):336-341. doi: 10.1007/s12603-016-0754-6.
The aim of this study was to investigate the association between the videofluoroscopic (VFS) signs of impaired efficacy (pharyngeal residue) and safety (aspiration) swallowing and the clinical/nutritional status of patients with suspect of dysphagia.
A cross-sectional study was conducted with patients submitted to videofluoroscopy.
Data of 76 patients were analyzed between March 2011 and December 2014.
The clinical history and VFS exams of patients ≥ 38 years were retrospectively analyzed.
88% patients presented Oropharyngeal Dysphagia (OD), 44.7% presented laryngeal penetration and 32% presented aspiration. 78% patients presented pharyngeal residue. Aspiration was associated with Head Neck Cancer (HNC) [Prevalence Ratio (PR): 2.27, p = 0.028] and cardiovascular disease (PR 1.96, p = 0.027). Underweight [Body Mass Index < 18.5 kg/m2] was not associated with the presence of aspiration. Underweight patients with OD had a higher prevalence rate of pharyngeal residue than those normally nourished (100% vs. 78%) (PR 1.34, p = 0.011). Pharyngeal residue was associated with male sex (PR 1.32, p = 0.040), neurodegenerative disease (PR 1.57, p = 0.021), stroke (PR 1.62, p = 0.009), cerebral palsy (PR 1.76, p = 0.006) and HNC (PR 1.73, p = 0.002).
In the present study, neurologic diseases, HNC, male sex and underweight were associated to impaired swallowing efficacy. Underweight, independently of the other variables, was not associated with impaired swallowing safety.
本研究旨在调查电视荧光吞咽造影(VFS)中有效性受损(咽部残留)和安全性(误吸)吞咽征象与吞咽困难疑似患者的临床/营养状况之间的关联。
对接受电视荧光吞咽造影的患者进行横断面研究。
分析了2011年3月至2014年12月期间76例患者的数据。
对年龄≥38岁患者的临床病史和VFS检查进行回顾性分析。
88%的患者存在口咽吞咽困难(OD),44.7%的患者存在喉穿透,32%的患者存在误吸。78%的患者存在咽部残留。误吸与头颈癌(HNC)[患病率比(PR):2.27,p = 0.028]和心血管疾病(PR 1.96,p = 0.027)相关。体重过轻[体重指数<18.5 kg/m²]与误吸的存在无关。患有OD的体重过轻患者咽部残留的患病率高于营养正常者(100%对78%)(PR 1.34,p = 0.011)。咽部残留与男性(PR 1.32,p = 0.040)、神经退行性疾病(PR 1.57,p = 0.021)、中风(PR 1.62,p = 0.009)、脑瘫(PR 1.76,p = 0.006)和HNC(PR 1.73,p = 0.002)相关。
在本研究中,神经系统疾病、HNC、男性和体重过轻与吞咽有效性受损相关。体重过轻独立于其他变量,与吞咽安全性受损无关。