Skip to main content
Journal cover image

Vocal Fold Paralysis/Paresis as a Marker for Poor Swallowing Outcomes After Thoracic Surgery Procedures.

Publication ,  Journal Article
Crowson, MG; Tong, BC; Lee, H-J; Song, Y; Misono, S; Jones, HN; Cohen, S
Published in: Dysphagia
December 2019

(1) To examine the association between vocal fold paresis/paralysis (VFP) and poor swallowing outcomes in a thoracic surgery cohort at the population level, and (2) to assess utilization of ENT/speech-language pathology intervention in these cases. The National Inpatient Sample (NIS) represents a 20% stratified sample of discharges from US hospitals. Using ICD-9 codes, discharges undergoing general thoracic surgical procedures between 2008 and 2013 were identified in the NIS. Sub-cohorts of discharges with VFP and those who utilized ENT/SLP services were also identified. Weighted logistic regression models were used to compare binary outcomes such as dysphagia, aspiration pneumonia, and other complications; generalized linear models with generalized estimating equations (GEE) were used to compare total hospital costs and length of stay (LOS). We identified a weighted estimate of 673,940 discharges following general thoracic surgery procedures. The weighted frequency of VFP was 3738 (0.55%). Compared to those without VFP, patients who discharged with VFP had increased odds of dysphagia (6.56, 95% CI 5.07-8.47), aspiration pneumonia (2.54, 95% CI 1.74-3.70), post-operative tracheotomy (3.10, 95% CI 2.16-4.45), and gastrostomy tube requirement (2.46, 95% CI 1.66-3.64). Discharges with VFP also had a longer length of stay and total hospital costs. Of the discharges with VFP, 15.7% received ENT/SLP intervention. VFP after general thoracic procedures is associated with negative swallowing-related health outcomes and higher costs. Despite these negative impacts, most patients with VFP do not receive ENT/SLP intervention, identifying a potential opportunity for improving adverse swallowing-related outcomes.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

Dysphagia

DOI

EISSN

1432-0460

Publication Date

December 2019

Volume

34

Issue

6

Start / End Page

904 / 915

Location

United States

Related Subject Headings

  • Vocal Cord Paralysis
  • Thoracic Surgical Procedures
  • Speech-Language Pathology & Audiology
  • Risk Factors
  • Risk Assessment
  • Middle Aged
  • Male
  • Humans
  • Female
  • Environmental Biomarkers
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Crowson, M. G., Tong, B. C., Lee, H.-J., Song, Y., Misono, S., Jones, H. N., & Cohen, S. (2019). Vocal Fold Paralysis/Paresis as a Marker for Poor Swallowing Outcomes After Thoracic Surgery Procedures. Dysphagia, 34(6), 904–915. https://doi.org/10.1007/s00455-019-09987-8
Crowson, Matthew G., Betty C. Tong, Hui-Jie Lee, Yao Song, Stephanie Misono, Harrison N. Jones, and Seth Cohen. “Vocal Fold Paralysis/Paresis as a Marker for Poor Swallowing Outcomes After Thoracic Surgery Procedures.Dysphagia 34, no. 6 (December 2019): 904–15. https://doi.org/10.1007/s00455-019-09987-8.
Crowson MG, Tong BC, Lee H-J, Song Y, Misono S, Jones HN, et al. Vocal Fold Paralysis/Paresis as a Marker for Poor Swallowing Outcomes After Thoracic Surgery Procedures. Dysphagia. 2019 Dec;34(6):904–15.
Crowson, Matthew G., et al. “Vocal Fold Paralysis/Paresis as a Marker for Poor Swallowing Outcomes After Thoracic Surgery Procedures.Dysphagia, vol. 34, no. 6, Dec. 2019, pp. 904–15. Pubmed, doi:10.1007/s00455-019-09987-8.
Crowson MG, Tong BC, Lee H-J, Song Y, Misono S, Jones HN, Cohen S. Vocal Fold Paralysis/Paresis as a Marker for Poor Swallowing Outcomes After Thoracic Surgery Procedures. Dysphagia. 2019 Dec;34(6):904–915.
Journal cover image

Published In

Dysphagia

DOI

EISSN

1432-0460

Publication Date

December 2019

Volume

34

Issue

6

Start / End Page

904 / 915

Location

United States

Related Subject Headings

  • Vocal Cord Paralysis
  • Thoracic Surgical Procedures
  • Speech-Language Pathology & Audiology
  • Risk Factors
  • Risk Assessment
  • Middle Aged
  • Male
  • Humans
  • Female
  • Environmental Biomarkers