Disclosures: Jayoon Choi, MD: No financial relationships or conflicts of interest
Objective: To investigate the relationship between peak cough flow (PCF) and risk of pneumonia in patients who were evaluated with videofluoroscopic swallowing study (VFSS).
Design: Retrospective, case-control study. Setting : Both inpatients and outpatients who performed VFSS at an academic hospital from 23 July 2012 through 12 June 2019. Participants : From 823 patients who performed both VFSS and PCF measurement on the same day, 2 patients were excluded because of insufficient result of VFSS, and the pneumonia (n=138) and control (n=683) groups were assigned based on medical records.
Interventions: not applicable.
Main Outcome Measures: sex, age, preceding conditions, modified Barthel index (MBI), mini mental state examination (MMSE), PCF (subgrouped in < 160, ≥160, and ≥270 L/min), presence of aspiration evaluated by VFSS, presence of pneumonia within 1 month regarding the date of VFSS confirmed by chart review.
Results: There were certain characteristics different between pneumonia and control groups. The pneumonia group were more likely to be male (78.3%), older than 65 years (87.7%), with neurodegenerative diseases as preceding condition (18.1%), and in poor functional level with lower value of MBI (39.1 ± 26.59), but no significant difference was found in MMSE between groups. Pneumonia group showed more aspiration rate and lower value of PCF. In multivariable logistic regression analysis including sex, preceding conditions, presence of aspiration, and PCF subgroups, PCF < 160 L/min and aspiration on VFSS were statistically significant risk factors of pneumonia (OR 14.34, 95% CI 1.84-111.6; OR 3.82, 95% CI 1.42-10.23). Conclusions: Both the presence of aspiration and impaired cough function with PCF < 160 L/min showed significant relationship with the development of pneumonia. We recommend physicians to measure cough flow in patients at the risk of pneumonia regardless of the presence of dysphagia. Patients with PCF < 160 L/min require more attention with lung care and should be encouraged with voluntary coughing strategy to prevent possible pulmonary complication.
Level of Evidence: Level III
To cite this abstract in AMA style:
Choi J, Baek S. Peak Voluntary Cough Flow and Oropharyngeal Dysphagia as Risk Factors for Pneumonia [abstract]. PM R. 2020; 12(S1)(suppl 1). https://pmrjabstracts.org/abstract/peak-voluntary-cough-flow-and-oropharyngeal-dysphagia-as-risk-factors-for-pneumonia/. Accessed May 12, 2025.« Back to AAPM&R Annual Assembly 2020
PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/peak-voluntary-cough-flow-and-oropharyngeal-dysphagia-as-risk-factors-for-pneumonia/