Guijo Laura Mochiatti, Pilon João Paulo Galletti, Cola Paula Cristina, da Silva Roberta Gonçalves, Onofri Suely Mayumi Motonaga
Postgraduate Students of the Speech, Language and Hearing Sciences Program, São Paulo State University-UNESP, Campus de Marília, Marília, SP, Brazil.
Dysphagia Lab, Speech, Language and Hearing Sciences Department, São Paulo State University-UNESP, Campus de Marília, Av. Hygino Muzzi Filho, 737-Mirante, Marília, SP, CEP 17.525-900, Brazil.
Eur Arch Otorhinolaryngol. 2025 Jan;282(1):371-375. doi: 10.1007/s00405-024-09069-y. Epub 2024 Nov 18.
To analyze the correlation between pharyngeal residue and penetration/aspiration in post-stroke individuals.
Cross-sectional, descriptive, retrospective, clinical study with 157 post-stroke individuals, 71 females and 86 males, aged 26 to 92 years (mean age: 67.2 years), all diagnosed by neurological assessment and imaging exams (computed tomography or magnetic resonance imaging), who underwent fiberoptic endoscopic evaluation of swallowing (FEES) in a rehabilitation center. They were served 5 mL of moderately thick liquid (level 3 in the International Dysphagia Diet Standardization Initiative [IDDSI]) in a spoon three times. Two expert raters in dysphagia assessed them with the Yale Pharyngeal Residue Severity Rating Scale (YPRSRS) and Penetration Aspiration Scale (PAS). Their interrater sensitivity agreement was analyzed with the Kappa test, and Spearman's rank correlation (r) verified the correlation between pharyngeal residue and the PAS and calculated the effect size (r).
YPRSRS in vallecula was positively correlated with PAS (r = 0.43; r = 0.18; p ≤ 0.000); YPRSRS in pyriform sinus, with PAS (r = 0.54; r = 0.29; p ≤ 0.000); and YPRSRS in both vallecula/pyriform sinus with PAS (r = 0.57; r = 0.32; p ≤ 0.000).
The severity of pharyngeal residue in post-stroke individuals with dysphagia is correlated with the level of penetration-aspiration.
分析中风后个体咽部残留与渗透/误吸之间的相关性。
对157名中风后个体进行横断面、描述性、回顾性临床研究,其中女性71名,男性86名,年龄在26至92岁之间(平均年龄:67.2岁),所有患者均通过神经学评估和影像学检查(计算机断层扫描或磁共振成像)确诊,并在康复中心接受了纤维内镜吞咽评估(FEES)。用勺子分三次给他们喂食5毫升中度浓稠液体(国际吞咽障碍饮食标准化倡议[IDDSI]中的3级)。两名吞咽障碍专家评估员使用耶鲁咽部残留严重程度评定量表(YPRSRS)和渗透误吸量表(PAS)对他们进行评估。用Kappa检验分析他们的评估者间敏感性一致性,Spearman等级相关性(r)验证咽部残留与PAS之间的相关性并计算效应量(r)。
会厌谷的YPRSRS与PAS呈正相关(r = 0.43;r = 0.18;p≤0.000);梨状窦的YPRSRS与PAS呈正相关(r = 0.54;r = 0.29;p≤0.000);会厌谷/梨状窦两者的YPRSRS与PAS呈正相关(r = 0.57;r = 0.32;p≤0.000)。
中风后吞咽困难个体的咽部残留严重程度与渗透-误吸水平相关。