Dysphagia in Thoracic Surgical Patients

Study Overview
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Brief Summary
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The proposed study seeks to determine the incidence of dysphagia and vocal fold mobility impairment (VFMI) in individuals undergoing throacic surgical procedures. It also seeks to determine the impact of postoperative swallowing impairment on health-related outcomes.

Detailed Description
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Swallowing impairment and VFMI are common, yet often overlooked, complications of thoracic surgical procedures. The true incidence of both dysphagia and VFMI in this patient population is unclear due to a lack of rigorous study using instrumental assessment techniques and validated outcomes in all patents undergoing thoracic surgery. The study is therefore aimed to determine the incidence of dysphagia and VFMI in this patient population and to characterize impairment profiles related to swallowing safety and efficiency. In addition, the study is also aimed to assess the relative impact of VFMI and dysphagia on health-related outcomes such as length of hospital stay, pneumonia, sepsis, reintubation, and discharge status

Official Title
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Dysphagia in Thoracic Surgical Patients: Incidence, Risk-factors, and Health Related Outcomes

Conditions
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Thoracic Diseases

Intervention / Treatment
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* Procedure: Fiberoptic Endoscopic Evaluation of Swallowing


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: adults aged 18 - 90 years old undergoing planned or emergent thoracic surgery via clamshell and/or extended thoracotomy confirmed negative COVID-19 test willing to participate in postoperative swallowing evaluation testing. Exclusion Criteria: individuals under the age of 18. pregnant or those testing positive for COVID-19 Additionally, the inability to demonstrate appropriate alertness and cognitive status following the procedure will exclude a participant from participating in this study to ensure protection of vulnerable individuals.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 90 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Thoracic Surgical Patients<br>Participants will undergo a Fiberoptic Endoscopic Evaluation of Swallowing (FEES) | Procedure: Fiberoptic Endoscopic Evaluation of Swallowing<br>* This procedure involves inserting a flexible laryngoscope that contains a light source and video camera on the end through the open passage of the nose towards the back of the throat in order to visualize the swallowing mechanism.<br>* Other names: FEES;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Penetration Aspiration Scale | This scale is a validated measure used by trained blinded clinicians to assign ratings of safety to swallowing bolus trials. The development and use of an 8-point, equal-appearing interval scale (8 being best; 1 being worst) to describe penetration and aspiration events are described. Scores are determined primarily by the depth to which material passes in the airway and by whether or not material entering the airway is expelled. | Baseline | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Yale Residue Severity Rating Scale | This scale is a validated measure used by trained blinded clinicians to assign ratings of efficiency to swallowing bolus trials. The Yale Pharyngeal Residue Severity Rating Scale was developed, standardized, and validated to provide reliable, anatomically defined, and image-based assessment of post-swallow pharyngeal residue severity as observed during fiberoptic endoscopic evaluation of swallowing (FEES). It is a five-point ordinal rating scale based on residue location (vallecula and pyriform sinus) and amount (none, trace, mild, moderate, and severe). | Baseline | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Dysphagia, Extubation, Vocal Fold Mobility Impairment, Peak Cough Flow (PCF)