Dynamic diagnostics: Do videofluoroscopic evaluations change swallowing management at Joondalup Health Campus?
Sarah Baildon1, HuiJun Chih2
1Ramsay Health Care – Joondalup Health Campus, Perth, Western Australia, Australia
2Clinical Trials Enabling Platform – Curtin University, Perth, Western Australia, Australia
Abstract
Introduction: Videofluoroscopy (VFSS) is a radiological evaluation used for assessment and management of dysphagia. Dysphagia can contribute to complications such as malnutrition, dehydration, aspiration of food and drink and subsequently aspiration pneumonia. Research shows up to 50% of people with dysphagia who aspirate, do so without any signs it is happening. Referral for VFSS is undertaken to objectively assess and manage dysphagia in order to improve health outcomes and mitigate health associated complications of dysphagia, such as increased hospital length of stay.
Aim: The purpose of this project was to evaluate the clinical utility of VFSS, patient access and whether it alters management of patients with dysphagia at Joondalup Health Campus (JHC).
Method: A retrospective audit of 103 files of inpatient’s who underwent VFSS was undertaken, with 6 variables evaluated to establish whether referrals for VFSS altered management of dysphagia changed following VFSS at JHC. Patient clinical characteristics, dietary status, recommendations and types of referral were reported by frequency (and percentages) for all patients, and by age group (18-65 years old (yo); over 65 yo). The association between VFSS and change in mode of nutrition was assessed for all patients, and by age group using Fisher’s Exact tests. Similarly, association between VFSS and change in dysphagia swallowing severity rating was assessed for all patients, and by age group using Fisher’s Exact tests.
Results: VFSS resulted in a change of at least one variable in 78% of patients, representing some change in management of patients with dysphagia post VFSS at JHC. Although the changes were not all of statistical significance, changes in diet/fluid for some patients potentially represented improvement in quality of life. Results support the ongoing use of VFSS at JHC as an adjunct to the clinical swallow evaluation for certain patients. Further studies would benefit from examining specific patient diagnostic presentations to examine the clinical utility of these VFSS evaluations in more detail.
Biography
Sarah is a senior speech pathologist currently working at Joondalup Health Campus in Perth. She obtained her Bachelor’s degree in Speech Pathology from the University of Canterbury in New Zealand. She has experience within adult tertiary hospitals internationally and specialises in dysphagia in the acute medical and oncology populations.