Objective: To identify the variables of videofluoroscopic swallowing study (VFSS) that are useful for predicting the risk of aspiration pneumonia in elderly patients with dysphagia. Methods: A total of 251 patients (aged 65 years or more) were included and divided into a pneumonia group (n=133) and a non-pneumonia group (n=118). The pneumonia group included patients who had been diagnosed with aspiration pneumonia, and individuals in the non-pneumonia group did not have pneumonia but were referred for VFSS. The medical records and results of VFSS were reviewed and compared between the groups retrospectively. Results: The pneumonia group exhibited a male preponderance and a higher 8-point Penetration-Aspiration Scale (8PPAS) score. The mean values of 8PPAS score for swallowing thick liquid and rice porridge was significantly higher in the pneumonia group. The pharyngeal delay time (PDT) and pharyngeal transit time (PTT) were significantly longer in the pneumonia group. The amounts of vallecular and pyriform sinus residue were increased in the pneumonia group. The delay in swallowing reflex and the decrease in laryngeal elevation were more frequently observed in the pneumonia group. Among those variables, PDT and PTT were identified as significant predictors of aspiration pneumonia based on logistic regression analysis. Conclusion The present study delineated the findings of VFSS, suggesting an increased risk of aspiration pneumonia in elderly patients with dysphagia. The results demonstrate that prolonged PDT and PTT are significant predictors of aspiration pneumonia.

Objective: To identify the variables of videofluoroscopic swallowing study (VFSS) that are useful for predicting the risk of aspiration pneumonia in elderly patients with dysphagia. Methods: A total of 251 patients (aged 65 years or more) were included and divided into a pneumonia group (n=133) and a non-pneumonia group (n=118). The pneumonia group included patients who had been diagnosed with aspiration pneumonia, and individuals in the non-pneumonia group did not have pneumonia but were referred for VFSS. The medical records and results of VFSS were reviewed and compared between the groups retrospectively. Results: The pneumonia group exhibited a male preponderance and a higher 8-point Penetration-Aspiration Scale (8PPAS) score. The mean values of 8PPAS score for swallowing thick liquid and rice porridge was significantly higher in the pneumonia group. The pharyngeal delay time (PDT) and pharyngeal transit time (PTT) were significantly longer in the pneumonia group. The amounts of vallecular and pyriform sinus residue were increased in the pneumonia group. The delay in swallowing reflex and the decrease in laryngeal elevation were more frequently observed in the pneumonia group. Among those variables, PDT and PTT were identified as significant predictors of aspiration pneumonia based on logistic regression analysis. Conclusion The present study delineated the findings of VFSS, suggesting an increased risk of aspiration pneumonia in elderly patients with dysphagia. The results demonstrate that prolonged PDT and PTT are significant predictors of aspiration pneumonia.

PURPOSE: Continuous renal replacement therapy (CRRT) has been developed and it has advantages, although the patients receiving CRRT still have a high mortality. This study was designed to compare the clinical characteristics of patients treated with CRRT between survivors and non-survivors. METHODS: From May 1992 to February 2000, continuous venovenous hemofiltration(CVVH) treatment was applied to 51 patients. Underlying disease, duration of CVVH treatment, blood pressure before and after the treatment were reviewed and APACHE III score, number of organ failures, blood pressure at the begining were compared between two groups. RESULTS: The average age was 56.3+/-5.6 years and the mortality was 86.3%(44 patients). The comorbid conditions were sepsis(66.7% of total patients), hepatic failure(33.3%), congestive heart failure(17.6%) and adult respiratory distress syndrome(9.8%). Mean arterial pressure(MAP) at the begining was 66.9+/-9.7 mmHg and MAP 2 hours after the treatment was 59.3+/-1.5 mmHg(p=0.076). APACHE III score was 59.5+/-3.5 in non-survivors and 56.0+/-0.9 in survivors and mean number of organ failures was 2.63+/-.98 in non-survivors and 1.68+/-.34 in survivors, but there was no difference between two groups(p=0.072). MAP at begining was significantly higher in survivors than that of non-survivors(87.86+/-3.15 vs. 63.49+/-7.04)(p=0.002). CONCLUSION: Most of the patients receiving CVVH have more than two organ failures. There were no significant difference in the number of organ failures and APACHE III score between survivor group and non-survivor group. It may be due to underlying disease of patients that MAP at the begining was lower in non-survivors than survivors. APACHE III score would not be a good prognostic predictor.
Acute Kidney Injury ; Adult ; APACHE ; Blood Pressure ; Estrogens, Conjugated (USP) ; Heart ; Humans ; Mortality ; Renal Replacement Therapy* ; Survivors