Abstract | BACKGROUND: METHODS: A total of 263 consecutive lung transplant patients were reviewed. Each underwent clinical swallowing evaluation early after surgery; 149 patients underwent additional fiberoptic or videofluoroscopic swallowing evaluation (SE). Results of SE were correlated with BOS, defined by accepted criteria, and mortality using Kaplan-Meier survival curves. Cox proportional hazard modeling assessed preoperative and postoperative variables associated with development of BOS and mortality. RESULTS: Mean follow-up was 920 ± 560 days. The SE identified tracheal aspiration and (or) laryngeal penetration in 70.5%. Preoperative tobacco abuse, gastroesophageal reflux, and cardiopulmonary bypass independently predicted oropharyngeal dysphagia. Peak FEV(1) (forced expiratory volume in the first second of expiration) alone independently predicted BOS (hazard ratio 0.98; confidence interval 0.975 to 0.992, p < 0.0001); oropharyngeal dysphagia was not associated with BOS. Independent predictors of mortality by multivariable analysis were ventilator dependence (p = 0.038) and peak FEV(1) (p < 0.0001); normal SE was associated with improved survival (hazard ratio 0.13; confidence interval 0.03 to 0.54, p = 0.03). CONCLUSIONS:
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Authors | B Zane Atkins, Rebecca P Petersen, Mani A Daneshmand, Joseph W Turek, Shu S Lin, R Duane Davis Jr |
Journal | The Annals of thoracic surgery
(Ann Thorac Surg)
Vol. 90
Issue 5
Pg. 1622-8
(Nov 2010)
ISSN: 1552-6259 [Electronic] Netherlands |
PMID | 20971276
(Publication Type: Journal Article)
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Copyright | Copyright © 2010 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved. |
Topics |
- Adult
- Bronchiolitis Obliterans
(etiology)
- Deglutition
- Deglutition Disorders
(complications, physiopathology)
- Female
- Forced Expiratory Volume
- Humans
- Lung Transplantation
(adverse effects, mortality)
- Male
- Middle Aged
- Proportional Hazards Models
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