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Am J Phys Med Rehabil. 2012 Sep;91(9):783-8. doi: 10.1097/PHM.0b013e3182556701.

Cough peak flow as a predictor of pulmonary morbidity in patients with dysphagia.

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  • 1Rehabilitation Unit, Fondazione Don Carlo Gnocchi, Centro IRCCS Santa Maria Nascente, Milan. Italy.

Abstract

OBJECTIVE:

The aim of this study was to ascertain whether an objective cough measure relates to the risk of pulmonary complications in dysphagic patients with persistent tracheobronchial aspiration.

DESIGN:

This is a retrospective observational study involving 55 dysphagic patients who underwent a modified barium swallow study and pulmonary function tests including cough peak flow measurement. The results were compared between subjects with and without pulmonary complications because of aspiration.

RESULTS:

The 18 patients (33%) with pulmonary complications had significantly lower mean cough peak flow values (202.2 ± 68.8 vs. 303.9 ± 80.7 liters/min; P < 0.001) than those without pulmonary complications. The finding of tracheobronchial coating in a modified barium swallow was not related to the occurrence of pulmonary morbidity. Receiver operating characteristic curve analysis showed that a CPF level lower than 242 liters/min predicted the development of pulmonary complications with a sensitivity of 77% and a specificity of 83%; the positive and negative predictive values were 65% and 90%, respectively.

CONCLUSIONS:

Our findings indicate that cough peak flow is a valuable predictor of respiratory prognosis in chronic aspiration. This finding suggests a new rehabilitation strategy aimed at improving cough flows for dysphagic patients.

PMID:
22561382
[PubMed - indexed for MEDLINE]
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