Comparative analysis of videofluoroscopy and pulse oximetry for aspiration identification in patients with dysphagia after stroke and non-dysphagics

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dc.authoridOge-Dasdogen, Ozlem/0000-0002-8954-0980
dc.authoridYildiz, Yelda/0009-0002-2452-1874
dc.authoridBengisu, Serkan/0000-0002-6580-1189
dc.contributor.authorBengisu, Serkan
dc.contributor.authorOge-Dasdogen, Oezlem
dc.contributor.authorYildiz, Hatice Yelda
dc.date.accessioned2024-05-19T14:39:09Z
dc.date.available2024-05-19T14:39:09Z
dc.date.issued2024
dc.departmentİstinye Üniversitesien_US
dc.description.abstractPurpose Dysphagia is a prevalent symptom observed in acute stroke. Several bedside screening tests are employed for the early detection of dysphagia. Pulse oximetry emerges as a practical and supportive method to augment the existing techniques utilized during bedside swallowing assessments. Desaturation levels, as measured by pulse oximetry, are acknowledged as indicative of aspiration by certain screening tests. However, the predictive capability of pulse oximetry in determining aspiration remains a subject of controversy. The objective of this study was to compare aspiration and oxygen desaturation levels by time and aspiration severity in dysphagic patients compared to healthy controls. It also aimed to evaluate the accuracy of pulse oximetry by comparing it with VFSS findings in detecting aspiration in both liquid (IDDSI-0) and semi-solid (IDDSI-4) consistencies.Materials and methods Eighty subjects (40 healthy and 40 acute stroke patients) participated. Patients suspected of dysphagia underwent videofluoroscopy as part of the stroke unit's routine procedure. Baseline SpO2 was measured before VFSS, and stabilized values were recorded. Sequential IDDSI-0 and IDDSI-4 barium tests were conducted with 5 ml boluses. Stabilized SPO2 values were recorded during swallowing and 3-min post-feeding. Patients with non-dysphagia received equal bolus monitoring. Changes in SPO2 during, before, and after swallowing were analyzed for each consistency in both groups.Results The study revealed a statistically significant difference in SPO2 between patients with dysphagia and controls for IDDSI-4 and IDSSI-0. In IDDSI-4, 20% of patients experienced SpO2 decrease compared to 2.5% in control group (p = 0.013). For IDDSI-0, 35% of patients showed SpO2 decrease, while none in the control group did (p = 0.0001). Aspiration rates were 2.5% in IDDSI-4 and 57.5% in IDDSI-0. In IDDSI-0, SpO2 decrease significantly correlated with aspiration (p = 0.0001). In IDDSI-4, 20.5% had SpO2 decrease without aspiration, and showing no significant difference (p = 0.613). Penetration-Aspiration Scale scores had no significant association with SpO2 decrease (p = 0.602). Pulse oximetry in IDDSI-4 had limited sensitivity (0%) and positive predictive value, (0%) while in IDDSI-0, it demonstrated acceptable sensitivity (60.9%) and specificity (100%) with good discrimination capability (AUC = 0.83).Conclusions A decrease in SPO2 may indicate potential aspiration but is insufficient alone for detection. This study proposes pulse oximetry as a valuable complementary tool in assessing dysphagia but emphasizes that aspiration cannot be reliably predicted based solely on SpO2 decrease.en_US
dc.description.sponsorshipIstanbul Atlas Universityen_US
dc.description.sponsorshipNo Statement Availableen_US
dc.identifier.doi10.1007/s00405-024-08613-0
dc.identifier.issn0937-4477
dc.identifier.issn1434-4726
dc.identifier.pmid38581573en_US
dc.identifier.scopus2-s2.0-85189651742en_US
dc.identifier.scopusqualityQ1en_US
dc.identifier.urihttps://doi.org10.1007/s00405-024-08613-0
dc.identifier.urihttps://hdl.handle.net/20.500.12713/4714
dc.identifier.wosWOS:001197945200004en_US
dc.identifier.wosqualityN/Aen_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.language.isoenen_US
dc.publisherSpringeren_US
dc.relation.ispartofEuropean Archives of Oto-Rhino-Laryngologyen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.snmz20240519_kaen_US
dc.subjectAspirationen_US
dc.subjectDeglutitionen_US
dc.subjectDysphagiaen_US
dc.subjectPulse Oximetryen_US
dc.subjectSwallowingen_US
dc.subjectSwallowing Disordersen_US
dc.titleComparative analysis of videofluoroscopy and pulse oximetry for aspiration identification in patients with dysphagia after stroke and non-dysphagicsen_US
dc.typeArticleen_US

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