Correlation between pharyngeal residue and penetration/aspiration in post-stroke individuals

Abstract

Purpose: To analyze the correlation between pharyngeal residue and penetration/aspiration in post-stroke individuals. Methods: Cross-sectional, descriptive, retrospective, clinical study with 157 post-stroke individuals, 71 females and 86 males, aged 26 to 92 years (mean age: 67.2 years), all diagnosed by neurological assessment and imaging exams (computed tomography or magnetic resonance imaging), who underwent fiberoptic endoscopic evaluation of swallowing (FEES) in a rehabilitation center. They were served 5 mL of moderately thick liquid (level 3 in the International Dysphagia Diet Standardization Initiative [IDDSI]) in a spoon three times. Two expert raters in dysphagia assessed them with the Yale Pharyngeal Residue Severity Rating Scale (YPRSRS) and Penetration Aspiration Scale (PAS). Their interrater sensitivity agreement was analyzed with the Kappa test, and Spearman’s rank correlation (r) verified the correlation between pharyngeal residue and the PAS and calculated the effect size (r2). Results: YPRSRS in vallecula was positively correlated with PAS (r = 0.43; r2 = 0.18; p ≤ 0.000); YPRSRS in pyriform sinus, with PAS (r = 0.54; r2 = 0.29; p ≤ 0.000); and YPRSRS in both vallecula/pyriform sinus with PAS (r = 0.57; r2 = 0.32; p ≤ 0.000). Conclusion: The severity of pharyngeal residue in post-stroke individuals with dysphagia is correlated with the level of penetration-aspiration.