Aspiration status per video-fluoroscopy swallow study
The aspiration status per VFSS, according to demographics, organ system involvement and medical diagnoses is shown in table 2. Throughout, overt aspirations were the least frequent finding, compared to no aspiration and silent aspiration. Out of the 22 infants aged under one year, only one showed overt aspirations alone on VFSS, whilst 10 (45%) had silent aspirations. Examining these 10 more closely, only three were suspected to have silent aspiration according to CFE, five were considered to have overt aspirations alone and two were thought to have no aspirations.
The silent aspiration group had a high representation of neurological and genetic abnormalities, and particularly of clinically suspected aspiration pneumonias. Structural abnormalities were associated with the lowest rates of aspiration.
Figure 3 shows the various types of aspiration encountered per texture trialed, as identified by VFSS. Among 113 children, 89 were evaluated with thin liquid, 70 with thick liquid, 60 with thin puree, 67 with thick puree and 47 with solids. For all consistencies, “no aspiration” was the most common, and “overt aspiration” the least common result. Of note, 25/70 (36%) of subjects had silent aspiration with thick liquid. The fewest aspirations were noted with solids, with all 5/47 (11%) showing silent aspirations.
A logistic regression model, relating medical diagnoses to the presence of aspiration (combined overt and silent), according to VFSS is shown in table 4. It shows that children with clinical aspiration lung disease and cerebral palsy were more prone to VFSS aspiration, with an OR of 3.2 and 9.8 respectively. These observations hold true following adjustment for age.