Study population
This was a retrospective single-center cohort study of children referred for VFSS at Schneider Children’s Medical Center of Israel (SCMCI), a tertiary pediatric hospital. Included were all children who successfully completed a VFSS between the ages of 0-18 years between the years 2011 and 2017. Excluded were children who failed performing the VFSS technically or due to lack of co-operation. The study was approved by the local Institutional Review Board, number ­­­­­­0516-17-­RMC.
Medical records were reviewed for diagnoses and coded for chiefly affected organ systems using a modified version of that described by Burklow et al9 which includes structural abnormalities, neurological conditions, behavioral issues, cardiorespiratory problems and metabolic dysfunction. We did not include behavioral and metabolic categories. To reflect the high prevalence of motility issues and genetic syndromes in our population, we added gastrointestinal and genetic categories. These affected organ systems were not scored as mutually exclusive. We further grouped patients according to medical diagnoses of particular interest, again not mutually exclusive, including Down’s syndrome, cerebral palsy, developmental delay, tracheo-esophageal fistula, congenital heart disease, preterm birth (prior to 37 completed weeks), bronchopulmonary dysplasia and clinically suspected aspiration lung disease. The latter included those subjects where a clinical diagnosis of aspiration lung disease was identified in medical records.