Cough Strength Is an Indicator of Aspiration Risk When Restarting Food Intake in Elderly Subjects With Community-Acquired Pneumonia.

BACKGROUND: The incidence of community-acquired pneumonia (CAP) is relatively high in elderly subjects. Cough peak flow (CPF) is an objective indicator of cough strength, and CPF evaluation might be useful to assess whether food intake can be restarted. We aimed to examine whether cough strength ass...

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Published in:Respiratory Care Vol. 65; no. 2; pp. 169 - 177
Main Authors: Yasunari Sakai, Masayoshi Ohira, Yoshiharu Yokokawa
Format: CEU pictorial research tables/charts Journal Article
Published: Mary Ann Liebert, Inc. Feb2020
Online Access:View this record in EBSCOhost
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      dt: Feb2020
      vid: 65
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      pub: Mary Ann Liebert, Inc.
      place: New Rochelle, New York
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        atl: Cough Strength Is an Indicator of Aspiration Risk When Restarting Food Intake in Elderly Subjects With Community-Acquired Pneumonia.
      aug:
        au:
          Yasunari Sakai
          Masayoshi Ohira
          Yoshiharu Yokokawa
        affil: Department of Rehabilitation, Shinshu University Hospital, Matusmoto, Japan
      sug:
        subj:
          Cough
          Aspiration Risk Factors
          Food Intake
          Community-Acquired Pneumonia In Old Age
          Peak Expiratory Flow Rate Evaluation
          Human
          Education, Continuing (Credit)
          Aged
          Cross Sectional Studies
          ROC Curve
          Sensitivity and Specificity
          Deglutition Physiology
          Japan
          C-Reactive Protein Blood
          Leukocyte Count
          Respiratory Function Tests
          Chi Square Test
          Mann-Whitney U Test
          Descriptive Statistics
          Data Analysis Software
          Aged, 80 and Over
          Male
          Female
          Questionnaires
          Aged: 65+ years
          Aged, 80 & over
          Male
          Female
      ab: BACKGROUND: The incidence of community-acquired pneumonia (CAP) is relatively high in elderly subjects. Cough peak flow (CPF) is an objective indicator of cough strength, and CPF evaluation might be useful to assess whether food intake can be restarted. We aimed to examine whether cough strength assessed with CPF can be used as an indicator of the aspiration risk when restarting food intake in elderly subjects with CAP. METHODS: This cross-sectional study included 82 elderly subjects with CAP between August 2016 and March 2018. CPF was measured using a peak flow meter, and we performed the repetitive saliva-swallowing test (RSST), which is a videoendoscopic evaluation of swallowing and is used to assess dysphagia and aspiration. Receiver operating characteristic (ROC) curve analysis was performed. The cutoff value was determined, and the area under the ROC was calculated. RESULTS: The areas under the RSST and CPF curves were 0.87 and 0.83, respectively. The RSST value for identifying the aspiration risk was 2.5 swallows. The sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio were 70.0%, 71.7%, 2.5, and 0.42, respectively. The CPF for identifying the aspiration risk was 190 L/min. The sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio were 82.6%, 69.4%, 2.7, and 0.25, respectively. CONCLUSIONS: Our findings suggest that cough strength assessed with CPF can be used as an indicator of the aspiration risk when restarting food intake in elderly subjects with CAP and that CPF evaluation is not inferior to the RSST. However, CPF evaluation should be performed together with swallowing screening tests to determine the aspiration risk.
      pubtype: Academic Journal
      doctype:
        CEU
        pictorial
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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