Prediction of Pneumonia in Acute Stroke Patients Using Tongue Pressure Measurements.
Swallowing dysfunction caused by stroke is a risk factor for aspiration pneumonia. Tongue pressure measurement is a simple and noninvasive method for evaluating swallowing dysfunction. We have hypothesized that low tongue pressure may be able to predict pneumonia occurrence in acute stroke patients....
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2016-01-01
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| Series: | PLoS ONE |
| Online Access: | http://europepmc.org/articles/PMC5089549?pdf=render |
| _version_ | 1818304916395917312 |
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| author | Masahiro Nakamori Naohisa Hosomi Kenichi Ishikawa Eiji Imamura Takeo Shishido Tomohiko Ohshita Mineka Yoshikawa Kazuhiro Tsuga Shinichi Wakabayashi Hirofumi Maruyama Masayasu Matsumoto |
| author_facet | Masahiro Nakamori Naohisa Hosomi Kenichi Ishikawa Eiji Imamura Takeo Shishido Tomohiko Ohshita Mineka Yoshikawa Kazuhiro Tsuga Shinichi Wakabayashi Hirofumi Maruyama Masayasu Matsumoto |
| author_sort | Masahiro Nakamori |
| collection | DOAJ |
| description | Swallowing dysfunction caused by stroke is a risk factor for aspiration pneumonia. Tongue pressure measurement is a simple and noninvasive method for evaluating swallowing dysfunction. We have hypothesized that low tongue pressure may be able to predict pneumonia occurrence in acute stroke patients. Tongue pressure was measured using balloon-type equipment in 220 acute stroke patients. The modified Mann Assessment of Swallowing Ability (MASA) score was evaluated independently on the same day. Tongue pressure was measured every week thereafter. An improvement in tongue pressure was observed within the first 2 weeks. Receiver operating curve analysis was performed to determine the ability of tongue pressure to predict modified MASA score <95, which suggests swallowing dysfunction. The optimal cutoff for tongue pressure was 21.6 kPa (χ2 = 45.82, p<0.001, sensitivity 95.9%, specificity 91.8%, area under the curve = 0.97). The tongue pressure was significantly lower in patients with pneumonia than in those without pneumonia. Using a Cox proportional hazard model for pneumonia onset with a cutoff tongue pressure value of 21.6 kPa and adjustment for age, sex, and National Institutes of Health Stroke Scale score at admission, the tongue pressure had additional predictive power for pneumonia onset (hazard ratio, 7.95; 95% confidence interval, 2.09 to 52.11; p = 0.0013). In the group with low tongue pressure, 27 of 95 patients showed improvement of tongue pressure within 2 weeks. Pneumonia occurred frequently in patients without improvement of tongue pressure, but not in patients with improvement (31/68 and 2/27, p<0.001). Tongue pressure is a sensitive indicator for predicting pneumonia occurrence in acute stroke patients. |
| first_indexed | 2024-12-13T06:18:18Z |
| format | Article |
| id | doaj.art-7cb9852a70b745b6a3ee82c3c879f232 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-13T06:18:18Z |
| publishDate | 2016-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-7cb9852a70b745b6a3ee82c3c879f2322022-12-21T23:56:55ZengPublic Library of Science (PLoS)PLoS ONE1932-62032016-01-011111e016583710.1371/journal.pone.0165837Prediction of Pneumonia in Acute Stroke Patients Using Tongue Pressure Measurements.Masahiro NakamoriNaohisa HosomiKenichi IshikawaEiji ImamuraTakeo ShishidoTomohiko OhshitaMineka YoshikawaKazuhiro TsugaShinichi WakabayashiHirofumi MaruyamaMasayasu MatsumotoSwallowing dysfunction caused by stroke is a risk factor for aspiration pneumonia. Tongue pressure measurement is a simple and noninvasive method for evaluating swallowing dysfunction. We have hypothesized that low tongue pressure may be able to predict pneumonia occurrence in acute stroke patients. Tongue pressure was measured using balloon-type equipment in 220 acute stroke patients. The modified Mann Assessment of Swallowing Ability (MASA) score was evaluated independently on the same day. Tongue pressure was measured every week thereafter. An improvement in tongue pressure was observed within the first 2 weeks. Receiver operating curve analysis was performed to determine the ability of tongue pressure to predict modified MASA score <95, which suggests swallowing dysfunction. The optimal cutoff for tongue pressure was 21.6 kPa (χ2 = 45.82, p<0.001, sensitivity 95.9%, specificity 91.8%, area under the curve = 0.97). The tongue pressure was significantly lower in patients with pneumonia than in those without pneumonia. Using a Cox proportional hazard model for pneumonia onset with a cutoff tongue pressure value of 21.6 kPa and adjustment for age, sex, and National Institutes of Health Stroke Scale score at admission, the tongue pressure had additional predictive power for pneumonia onset (hazard ratio, 7.95; 95% confidence interval, 2.09 to 52.11; p = 0.0013). In the group with low tongue pressure, 27 of 95 patients showed improvement of tongue pressure within 2 weeks. Pneumonia occurred frequently in patients without improvement of tongue pressure, but not in patients with improvement (31/68 and 2/27, p<0.001). Tongue pressure is a sensitive indicator for predicting pneumonia occurrence in acute stroke patients.http://europepmc.org/articles/PMC5089549?pdf=render |
| spellingShingle | Masahiro Nakamori Naohisa Hosomi Kenichi Ishikawa Eiji Imamura Takeo Shishido Tomohiko Ohshita Mineka Yoshikawa Kazuhiro Tsuga Shinichi Wakabayashi Hirofumi Maruyama Masayasu Matsumoto Prediction of Pneumonia in Acute Stroke Patients Using Tongue Pressure Measurements. PLoS ONE |
| title | Prediction of Pneumonia in Acute Stroke Patients Using Tongue Pressure Measurements. |
| title_full | Prediction of Pneumonia in Acute Stroke Patients Using Tongue Pressure Measurements. |
| title_fullStr | Prediction of Pneumonia in Acute Stroke Patients Using Tongue Pressure Measurements. |
| title_full_unstemmed | Prediction of Pneumonia in Acute Stroke Patients Using Tongue Pressure Measurements. |
| title_short | Prediction of Pneumonia in Acute Stroke Patients Using Tongue Pressure Measurements. |
| title_sort | prediction of pneumonia in acute stroke patients using tongue pressure measurements |
| url | http://europepmc.org/articles/PMC5089549?pdf=render |
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