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01-12-2019 | Esophagography | Original Article

The Modified Barium Swallow Impairment Profile as a Predictor of Clinical Outcomes of Admission for Pneumonia or Choking in Dysphagic Patients with Parkinson’s Disease

Authors: Amanda Hui-Juan Kooi, Jasmine Pei-Ling Boo, Samuel Yong-Ern Ng, Sanchalika Acharyya, Kwang-Hwee Goh, Kay-Yaw Tay, Wing-Lok Au, Louis Chew-Seng Tan

Published in: Dysphagia | Issue 6/2019

Abstract

Dysphagia increases risk of pneumonia in patients with Parkinson’s disease (PD). However, no studies have investigated the association between objective measures of swallowing dysfunction and clinical outcomes. Therefore, we aimed to study the link between scores obtained on the modified barium swallow impairment scale profile (MBSImP) and hospital admissions for pneumonia and choking, in groups of patients with PD on different feeding modes. 157 patients who completed MBS studies were divided into three groups based on their feeding modes (oral, enteral, and rejected enteral feeding with oral feeding at own risk). Videos were analysed using the MBSImP. We evaluated the association of the oral, pharyngeal, and combined scores, with risk of admission for pneumonia and choking. Kaplan–Meier plots and log-rank tests were used to compare survival distributions among feeding groups. Cox regression models were generated to estimate hazard ratios (HRs) and 95% confidence intervals. Patients in the group that rejected enteral feeding scored the highest on the MBSImP, followed by enteral then oral feeding. Within the group that rejected enteral feeding, higher pharyngeal (HR = 3.73, p = 0.036) and combined scores (HR = 1.63, p = 0.034) significantly increased the risk of pneumonia and choking. In the enteral feeding group, higher oral subscores (HR = 2.16, p = 0.011) increased risk for the event, while higher pharyngeal (HR = 0.40, p = 0.004) subscores reduced risk for pneumonia and choking. This is the first study to analyse the association of MBSImP scores with clinical outcomes in PD patients. Patients who rejected enteral feeding had the highest risk for pneumonia and choking that could be predicted by their MBSImP scores. In the enteral feeding group, this risk was partially reversed. Compliance with feeding modes reduces the risk of pneumonia and choking.

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Title: The Modified Barium Swallow Impairment Profile as a Predictor of Clinical Outcomes of Admission for Pneumonia or Choking in Dysphagic Patients with Parkinson’s Disease
Authors: Amanda Hui-Juan Kooi
Jasmine Pei-Ling Boo
Samuel Yong-Ern Ng
Sanchalika Acharyya
Kwang-Hwee Goh
Kay-Yaw Tay
Wing-Lok Au
Louis Chew-Seng Tan
Publication date: 01-12-2019
Publisher: Springer US
Keywords: Esophagography
Pneumonia
Parkinson's Disease
Dysphagia
Dysphagia
Dysphagia
Published in: Dysphagia / Issue 6/2019
Print ISSN: 0179-051X
Electronic ISSN: 1432-0460
DOI: https://doi.org/10.1007/s00455-019-09986-9

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The Modified Barium Swallow Impairment Profile as a Predictor of Clinical Outcomes of Admission for Pneumonia or Choking in Dysphagic Patients with Parkinson’s Disease

Abstract

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