Audiology Phoniatry Service, Infermi Hospital, AUSL Romagna, Rimini, Italy.
Audiology Service, Policlinico Modena, Italy.
Acta Otorhinolaryngol Ital. 2018 Dec;38(6):511-516. doi: 10.14639/0392-100X-1967.
The aim of this study was to identify which characteristics, collected by bedside swallowing evaluation (BSE) and fiberoptic endoscopic evaluation of swallowing (FEES), are a risk or a protective factor for aspiration. This retrospective study included data on 1577 consecutive patients, collected by BSE and FEES. Bivariate analysis was performed to verify the association of each variable with aspiration (Chi-Square test). The variables associated with aspiration were entered into a multivariate logistic model to quantify this association. Several variables were significantly associated (p < 0.05) with aspiration; cooperation, sensation, laryngeal elevation and direct therapy were found to be protective factors against aspiration. The regression model identified the most variables related with aspiration, among which tracheotomy, material pooling and spillage. Patients able to perform dry swallows were 77% less likely to aspirate (protective factor). Several variables are involved in protection of airways during swallowing. Their interaction, in patients with swallowing disorders, offers the clinician the best means of interpreting BSE and FEES.
本研究旨在确定通过床边吞咽评估（BSE）和纤维内镜吞咽评估（FEES）收集的哪些特征是吸入的风险或保护因素。这项回顾性研究包括通过 BSE 和 FEES 收集的 1577 例连续患者的数据。进行了双变量分析以验证每个变量与吸入的关联（卡方检验）。将与吸入相关的变量纳入多变量逻辑回归模型以量化这种关联。有几个变量与吸入显著相关（p < 0.05）；合作、感觉、喉抬高和直接治疗被认为是预防吸入的保护因素。回归模型确定了与吸入最相关的变量，其中包括气管切开术、物质积聚和溢出。能够进行干吞咽的患者发生吸入的可能性降低了 77%（保护因素）。在吞咽障碍患者中，有几个变量参与了气道的保护。它们之间的相互作用为临床医生提供了解释 BSE 和 FEES 的最佳手段。
