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...
| Published in: | Respiratory Care Vol. 65; no. 2; pp. 169 - 177 |
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| Main Authors: | , , |
| Format: | CEU pictorial research tables/charts Journal Article |
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Mary Ann Liebert, Inc.
Feb2020
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=141657285&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 141657285 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00201324 4GG jtl: Respiratory Care issn: 00201324 maglogo: N pubinfo: dt: Feb2020 vid: 65 iid: 2 pid: 1365 pub: Mary Ann Liebert, Inc. place: New Rochelle, New York artinfo: ui: 141657285 141657285 141657285 10.4187/respcare.07067 141657285 ppf: 169 ppct: 8 formats: fmt: @attributes: type: P tig: 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 refInfo: holdings: @attributes: islocal: N |
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