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Published in: Dysphagia 5/2017

01-10-2017 | Original Article

The Eating Assessment Tool-10 Predicts Aspiration in Adults with Stable Chronic Obstructive Pulmonary Disease

Authors: Julie Regan, Susan Lawson, Vânia De Aguiar

Published in: Dysphagia | Issue 5/2017

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Abstract

Adults with COPD frequently present with dysphagia, which often leads to clinical complications and hospital admissions. This study investigates the ability of the Eating Assessment Tool (EAT-10) to predict aspiration during objective dysphagia evaluation in adults with stable COPD. Thirty adults (20 male, 10 female; mean age = 69.07 ± 16.82) with stable COPD attended an outpatient dysphagia clinic for a fiberoptic endoscopic evaluation of swallowing (FEES) in an acute teaching hospital (January 2015–November 2016). During evaluations, individuals completed an EAT-10 rating scale followed immediately by a standardised FEES exam. Aspiration status during FEES was rated using the penetration–aspiration scale by clinicians blinded to EAT-10 scores. Data were retrospectively analysed. Significant differences in mean EAT-10 scores were found between aspirators (16.3; SEM = 2.165) and non-aspirators (7.3; SEM = 1.009) (p = 0.000). The EAT-10 predicted aspiration with a high level of accuracy (AUC = 0.88). An EAT-10 cut-off value of >9 presented a sensitivity of 91.67, specificity of 77.78 with positive and negative likelihood ratios of 4.12 and 0.11, respectively. Positive and negative predictive values were 73.30 and 93.30, respectively. Diagnostic odds ratio was 38.50 (p < 0.01, CI 3.75–395.42). EAT-10 is a quick, easy to administer tool, which can accurately predict the presence of aspiration in adults with COPD. The scale can also very accurately exclude the absence of aspiration, helping clinicians to determine the need for onward referral for a comprehensive dysphagia evaluation. This may ultimately reduce clinical complications and hospital admissions resulting from dysphagia in this clinical population.
Literature
2.
go back to reference Global Strategy for the Diagnosis. Management, and prevention of chronic obstructive pulmonary disease (GOLD). 2008. Accessed 26 Jan 2009. Global Strategy for the Diagnosis. Management, and prevention of chronic obstructive pulmonary disease (GOLD). 2008. Accessed 26 Jan 2009.
3.
go back to reference Mannino DM. COPD: epidemiology, prevalence, morbidity and mortality, and disease heterogeneity. Chest. 2002;121:121S–6S.CrossRefPubMed Mannino DM. COPD: epidemiology, prevalence, morbidity and mortality, and disease heterogeneity. Chest. 2002;121:121S–6S.CrossRefPubMed
5.
go back to reference Cvejic L, Harding R, Churchward T, Turton A, Finlay P, Massey D, Bardin PG, Guy P. Laryngeal penetration and aspiration in individuals with stable COPD. Respirology. 2011;16:269–75.CrossRefPubMed Cvejic L, Harding R, Churchward T, Turton A, Finlay P, Massey D, Bardin PG, Guy P. Laryngeal penetration and aspiration in individuals with stable COPD. Respirology. 2011;16:269–75.CrossRefPubMed
6.
go back to reference Mokhlesi B, Logemann JA, Rademaker AW, Stangl CA, Corbridge TC. Oropharyngeal deglutition in stable COPD. Chest. 2002;121(2):361–9.CrossRefPubMed Mokhlesi B, Logemann JA, Rademaker AW, Stangl CA, Corbridge TC. Oropharyngeal deglutition in stable COPD. Chest. 2002;121(2):361–9.CrossRefPubMed
7.
go back to reference Shaker R, Li Q, Ren J, Townsend WF, Dodds WJ, Martin BJ, Kern MK, Rynders A. Coordination of deglutition and phases of respiration: effect of aging, tachypnea, bolus volume, and chronic obstructive pulmonary disease. Am J Physiol. 1992;263(5.1):750–5. Shaker R, Li Q, Ren J, Townsend WF, Dodds WJ, Martin BJ, Kern MK, Rynders A. Coordination of deglutition and phases of respiration: effect of aging, tachypnea, bolus volume, and chronic obstructive pulmonary disease. Am J Physiol. 1992;263(5.1):750–5.
8.
go back to reference Gross DR, Atwood CW, Ross SB, Olszewski JW, Eichhorn KA. The coordination of breathing and swallowing in chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2009;179:559–65.CrossRefPubMed Gross DR, Atwood CW, Ross SB, Olszewski JW, Eichhorn KA. The coordination of breathing and swallowing in chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2009;179:559–65.CrossRefPubMed
10.
go back to reference Good-Fratturelli MD, Curlee RF, Holle JL. Prevalence and nature of dysphagia in VA patients with COPD referred for videofluoroscopic swallow examination. J Commun Disord. 2000;33(2):93–110.CrossRefPubMed Good-Fratturelli MD, Curlee RF, Holle JL. Prevalence and nature of dysphagia in VA patients with COPD referred for videofluoroscopic swallow examination. J Commun Disord. 2000;33(2):93–110.CrossRefPubMed
11.
go back to reference Zheng Z, Wu Z, Liu N, Chen P, Hou P, Wang X, Fu Y, Liang W, Chen R. Silent aspiration in patients with exacerbation of COPD. Eur Respir J. 2016;48(2):570–3.CrossRefPubMed Zheng Z, Wu Z, Liu N, Chen P, Hou P, Wang X, Fu Y, Liang W, Chen R. Silent aspiration in patients with exacerbation of COPD. Eur Respir J. 2016;48(2):570–3.CrossRefPubMed
12.
go back to reference Stein M, Williams AJ, Grossman F, Weinberg AS, Zuckerbraun L. Cricopharyngeal dysfunction in chronic obstructive pulmonary disease. Chest. 1990;97(2):347–52.CrossRefPubMed Stein M, Williams AJ, Grossman F, Weinberg AS, Zuckerbraun L. Cricopharyngeal dysfunction in chronic obstructive pulmonary disease. Chest. 1990;97(2):347–52.CrossRefPubMed
13.
go back to reference Clayton NA, Carnaby-Mann GD, Peters MJ, Ing AJ. The effect of chronic obstructive pulmonary disease on laryngopharyngeal sensitivity. Ear Nose Throat J. 2012;91(9):370–82.PubMed Clayton NA, Carnaby-Mann GD, Peters MJ, Ing AJ. The effect of chronic obstructive pulmonary disease on laryngopharyngeal sensitivity. Ear Nose Throat J. 2012;91(9):370–82.PubMed
14.
go back to reference Coelho CA. Preliminary findings on the nature of dysphagia in patients with chronic obstructive pulmonary disease. Dysphagia. 1987;2(1):28–31.CrossRefPubMed Coelho CA. Preliminary findings on the nature of dysphagia in patients with chronic obstructive pulmonary disease. Dysphagia. 1987;2(1):28–31.CrossRefPubMed
15.
go back to reference Takada K, Matsumoto S, Kojima E, Iwata S, Okachi S, Ninomiya K, Morioka H, Tanaka K, Enomoto Y. Prospective evaluation of the relationship between acute exacerbations of COPD and gastroesophageal reflux disease diagnosed by questionnaire. Respir Med. 2011;105(10):1531–6.CrossRefPubMed Takada K, Matsumoto S, Kojima E, Iwata S, Okachi S, Ninomiya K, Morioka H, Tanaka K, Enomoto Y. Prospective evaluation of the relationship between acute exacerbations of COPD and gastroesophageal reflux disease diagnosed by questionnaire. Respir Med. 2011;105(10):1531–6.CrossRefPubMed
16.
go back to reference Chatila WM, Thomashow BM, Minai OA, Criner GJ, Make BJ. Comorbidities in chronic obstructive pulmonary disease. Proc Am Thorac Soc. 2008;5(4):549–55.CrossRefPubMedPubMedCentral Chatila WM, Thomashow BM, Minai OA, Criner GJ, Make BJ. Comorbidities in chronic obstructive pulmonary disease. Proc Am Thorac Soc. 2008;5(4):549–55.CrossRefPubMedPubMedCentral
18.
go back to reference Schermer TRJ, Saris CGJ, Van Den Bosch WJHM, Chavannes NH, Van Schayck CP, Dekhuijzen PNR, Van Weel C. Exacerbations and associated healthcare cost in patients with COPD in general practice. Monaldi Arch Chest Dis. 2016. doi:10.4081/monaldi.2006.558. Schermer TRJ, Saris CGJ, Van Den Bosch WJHM, Chavannes NH, Van Schayck CP, Dekhuijzen PNR, Van Weel C. Exacerbations and associated healthcare cost in patients with COPD in general practice. Monaldi Arch Chest Dis. 2016. doi:10.​4081/​monaldi.​2006.​558.
19.
go back to reference Belafsky PC, Mouadeb DA, Rees CJ, Pryor JC, Postma GN, Allen J, Leonard RJ. Validity and reliability of the Eating Assessment Tool (EAT-10). Ann Otol Rhinol Laryngol. 2008;117(12):919–24.CrossRefPubMed Belafsky PC, Mouadeb DA, Rees CJ, Pryor JC, Postma GN, Allen J, Leonard RJ. Validity and reliability of the Eating Assessment Tool (EAT-10). Ann Otol Rhinol Laryngol. 2008;117(12):919–24.CrossRefPubMed
20.
go back to reference Cheney DM, Siddiqui MT, Litts JK, Kuhn MA, Belafsky PC. The ability of the 10-item eating assessment tool (EAT-10) to predict aspiration risk in persons with dysphagia. Ann Otol Rhinol Laryngol. 2015;124(5):351–4.CrossRefPubMed Cheney DM, Siddiqui MT, Litts JK, Kuhn MA, Belafsky PC. The ability of the 10-item eating assessment tool (EAT-10) to predict aspiration risk in persons with dysphagia. Ann Otol Rhinol Laryngol. 2015;124(5):351–4.CrossRefPubMed
21.
go back to reference Plowman EK, Tabor LC, Robison R, Gaziano J, Dion C, Watts SA, Vu T, Gooch C. Discriminant ability of the Eating Assessment Tool-10 to detect aspiration in individuals with amyotrophic lateral sclerosis. Neurogastroenterol Motil. 2016;28(1):85–90.CrossRefPubMed Plowman EK, Tabor LC, Robison R, Gaziano J, Dion C, Watts SA, Vu T, Gooch C. Discriminant ability of the Eating Assessment Tool-10 to detect aspiration in individuals with amyotrophic lateral sclerosis. Neurogastroenterol Motil. 2016;28(1):85–90.CrossRefPubMed
22.
go back to reference Arrese LC, Carrau R, Plowman EK. Relationship between the Eating Assessment Tool-10 and objective clinical ratings of swallowing function in individuals with head and neck cancer. Dysphagia. 2016;32:83–9.CrossRefPubMed Arrese LC, Carrau R, Plowman EK. Relationship between the Eating Assessment Tool-10 and objective clinical ratings of swallowing function in individuals with head and neck cancer. Dysphagia. 2016;32:83–9.CrossRefPubMed
23.
go back to reference Rofes L, Arreola V, Mukherjee R, Clave P. Sensitivity and specificity of the Eating Assessment Tool and the volume-viscosity swallow test for clinical evaluation of oropharyngeal dysphagia. Neurogastroenterol Motil. 2014;26(9):1256–65.CrossRefPubMedPubMedCentral Rofes L, Arreola V, Mukherjee R, Clave P. Sensitivity and specificity of the Eating Assessment Tool and the volume-viscosity swallow test for clinical evaluation of oropharyngeal dysphagia. Neurogastroenterol Motil. 2014;26(9):1256–65.CrossRefPubMedPubMedCentral
24.
go back to reference Wakabayashi H, Matsushima M. Dysphagia assessed by the 10-item Eating Assessment Tool is associated with nutritional status and activities of daily living in elderly individuals requiring long-term care. J Nutr Health Aging. 2016;20(1):22–7.CrossRefPubMed Wakabayashi H, Matsushima M. Dysphagia assessed by the 10-item Eating Assessment Tool is associated with nutritional status and activities of daily living in elderly individuals requiring long-term care. J Nutr Health Aging. 2016;20(1):22–7.CrossRefPubMed
25.
go back to reference Rosenbek JC, Robbins JA, Roecker EB, Coyle JL, Wood JL. A penetration–aspiration scale. Dysphagia. 1996;11(2):93–8.CrossRefPubMed Rosenbek JC, Robbins JA, Roecker EB, Coyle JL, Wood JL. A penetration–aspiration scale. Dysphagia. 1996;11(2):93–8.CrossRefPubMed
26.
go back to reference Colodny N. Interjudge and intrajudge reliabilities in fiberoptic endoscopic evaluation of swallowing (Fees®) using the penetration–aspiration scale: a replication study. Dysphagia. 2002;17(4):308–15.CrossRefPubMed Colodny N. Interjudge and intrajudge reliabilities in fiberoptic endoscopic evaluation of swallowing (Fees®) using the penetration–aspiration scale: a replication study. Dysphagia. 2002;17(4):308–15.CrossRefPubMed
27.
go back to reference Kelly AM, Drinnan MJ, Leslie P. Assessing penetration and aspiration: how do videofluoroscopy and fiberoptic endoscopic evaluation of swallowing compare? Laryngoscope. 2007;117(10):1723–7.CrossRefPubMed Kelly AM, Drinnan MJ, Leslie P. Assessing penetration and aspiration: how do videofluoroscopy and fiberoptic endoscopic evaluation of swallowing compare? Laryngoscope. 2007;117(10):1723–7.CrossRefPubMed
28.
go back to reference Pisegna JM, Langmore SE. Parameters of instrumental swallowing evaluations: describing a diagnostic dilemma. Dysphagia. 2016;31(3):462–72.CrossRefPubMed Pisegna JM, Langmore SE. Parameters of instrumental swallowing evaluations: describing a diagnostic dilemma. Dysphagia. 2016;31(3):462–72.CrossRefPubMed
30.
go back to reference Dollaghan CA. The handbook for evidence-based practice in communication disorders. Baltimore: Paul H Brookes Publishing Company; 2007. Dollaghan CA. The handbook for evidence-based practice in communication disorders. Baltimore: Paul H Brookes Publishing Company; 2007.
31.
go back to reference Almirall J, Rofes L, Serra-Prat M, Icart R, Palomera E, Arreola V, Clave P. Oropharyngeal dysphagia is a risk factor for community-acquired pneumonia in the elderly. Eur Respir J. 2013;41:923–8.CrossRefPubMed Almirall J, Rofes L, Serra-Prat M, Icart R, Palomera E, Arreola V, Clave P. Oropharyngeal dysphagia is a risk factor for community-acquired pneumonia in the elderly. Eur Respir J. 2013;41:923–8.CrossRefPubMed
32.
go back to reference Ickenstein GW, Riecker A, Höhlig C, Müller R, Becker U, Reichmann H, Prosiegel M. Pneumonia and in-hospital mortality in the context of neurogenic oropharyngeal dysphagia (NOD) in stroke and a new NOD step-wise concept. J Neurol. 2010;257:1492–9.CrossRefPubMedPubMedCentral Ickenstein GW, Riecker A, Höhlig C, Müller R, Becker U, Reichmann H, Prosiegel M. Pneumonia and in-hospital mortality in the context of neurogenic oropharyngeal dysphagia (NOD) in stroke and a new NOD step-wise concept. J Neurol. 2010;257:1492–9.CrossRefPubMedPubMedCentral
33.
go back to reference Hinchey JA, Shephard T, Furie K, Smith D, Wang D, Tonn S. Formal dysphagia screening protocols prevent pneumonia. Stroke. 2005;36:1972–6.CrossRefPubMed Hinchey JA, Shephard T, Furie K, Smith D, Wang D, Tonn S. Formal dysphagia screening protocols prevent pneumonia. Stroke. 2005;36:1972–6.CrossRefPubMed
34.
go back to reference Rofes L, Arreola V, Romea M, Palomera E, Almirall J, Cabré M, Serra-Prat M, Clavé P. Pathophysiology of oropharyngeal dysphagia in frail elderly. Neurogastroenterol Motil. 2010;22:851.CrossRefPubMed Rofes L, Arreola V, Romea M, Palomera E, Almirall J, Cabré M, Serra-Prat M, Clavé P. Pathophysiology of oropharyngeal dysphagia in frail elderly. Neurogastroenterol Motil. 2010;22:851.CrossRefPubMed
35.
go back to reference Whiting PF, Rutjes AW, Westwood ME, Mallett S, Deeks JJ, Reitsma JB, Leeflang MM, Sterne JA, Bossuyt PM. QUADAS-2: a revised tool for the quality assessment of diagnostic accuracy studies. Ann Intern Med. 2011;155(8):529–36.CrossRefPubMed Whiting PF, Rutjes AW, Westwood ME, Mallett S, Deeks JJ, Reitsma JB, Leeflang MM, Sterne JA, Bossuyt PM. QUADAS-2: a revised tool for the quality assessment of diagnostic accuracy studies. Ann Intern Med. 2011;155(8):529–36.CrossRefPubMed
36.
37.
go back to reference Cordier R, Joosten A, Clavé P, Schindler A, Bülow M, Demir N, Serel Arslan S, Speyer R. Evaluating the psychometric properties of the Eating Assessment Tool (EAT-10) using rasch analysis. Dysphagia. 2016;32:250–60.CrossRefPubMed Cordier R, Joosten A, Clavé P, Schindler A, Bülow M, Demir N, Serel Arslan S, Speyer R. Evaluating the psychometric properties of the Eating Assessment Tool (EAT-10) using rasch analysis. Dysphagia. 2016;32:250–60.CrossRefPubMed
Metadata
Title
The Eating Assessment Tool-10 Predicts Aspiration in Adults with Stable Chronic Obstructive Pulmonary Disease
Authors
Julie Regan
Susan Lawson
Vânia De Aguiar
Publication date
01-10-2017
Publisher
Springer US
Published in
Dysphagia / Issue 5/2017
Print ISSN: 0179-051X
Electronic ISSN: 1432-0460
DOI
https://doi.org/10.1007/s00455-017-9822-2

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