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Titre : | Determining Peak Cough Flow Cutoff Values to Predict Aspiration Pneumonia Among Patients With Dysphagia Using the Citric Acid Reflexive Cough Test (2018) |
Auteurs : | Donggyun Sohn ; Geun-Young Park ; HyungJung Koo |
Type de document : | Article |
Dans : | Archives of Physical Medicine and Rehabilitation (Vol. 99, n° 12, 2018) |
Article en page(s) : | p. 2532-2539 |
Langues: | Anglais |
Descripteurs : |
HE Vinci Aspiration ; Rééducation et réadaptation ; Toux ; Troubles de la déglutition |
Mots-clés: | Pneumonia ; Pneumopathie de déglutition ; Citric acid ; Acide citrique ; Cough ; Deglutition disorders |
Résumé : |
Objective To investigate the clinical usefulness of the peak cough flow generated during the citric acid reflexive cough test (0.28 mol/L) by determining the appropriate cutoff values that could accurately predict aspiration pneumonia within the first 6 months after onset. Design Retrospective analysis of a prospectively maintained database. Setting University-affiliated hospital. Participants Patients (N=163) with first-ever diagnosed dysphagia attributable to cerebrovascular disease, who had undergone the citric acid reflexive cough test on the same day they underwent the instrumental assessment of swallowing, such as videofluoroscopy or the functional endoscopic swallowing test. Interventions Not applicable. Main Outcome Measures Peak cough flow (L/min) from the citric acid reflexive cough test. Results A final 163 patients had full medical records with 6-month follow-up. Receiver operating curve analysis showed that peak cough flow cutoff values set at 59 L/min were significantly associated with aspiration pneumonia (area under the curve [AUC] 95% confidence interval =0.88 [0.83-0.93]). This cutoff value significantly (P<.001 predicted the risk of aspiration pneumonia with an odds ratio a multivariate regression logistic analysis model including initial dysphagia severity low body mass index and decreased level cognition showed that inclusion peak cough flow from citric acid reflexive test significantly improved predictive within first months after onset vs> Conclusions Those with reflexive cough strength less than 59 L/min may be at high risk of respiratory infections within the first 6 months after dysphagia onset. Objective measurement of reflexive cough strength may help to predict those at risk of aspiration pneumonia. |
Disponible en ligne : | Oui |
En ligne : | https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/article/pii/S0003999318304416 |