Clinical predictors of aspiration on radionuclide salivagrams in children.
OBJECTIVE
To determine patient characteristics and clinical factors that are predictive of positive radionuclide salivagram results.


METHODS
Retrospective chart review (spanning 32 months).


METHODS
Tertiary care children's hospital.


METHODS
The study included 129 consecutive pediatric patients with suspected chronic aspiration.


METHODS
All subjects underwent radionuclide salivagrams to evaluate for aspiration.


METHODS
The association of 16 patient characteristics and clinical factors (eg, age, sex, diagnoses, study indications, medications, and previous surgical procedures) with salivagram results. Each factor was examined individually (chi(2) or Fisher exact test). For those factors that were significantly associated with positive salivagram results, the risk was estimated with the odds ratio (OR). A multivariable logistic regression model was constructed to determine how well significantly associated factors together predicted positive salivagram results.


RESULTS
The mean (SD) patient age was 4.5 (5.4) years. There were 84 boys (65%) and 45 girls (35%). Aspiration was identified in 27 of 129 salivagrams (21%). On univariate analysis, positive salivagram results were significantly associated with chronic respiratory infections and/or pneumonia (OR, 2.6), prescription of antireflux medications (OR, 2.7), developmental delay (OR, 2.8), and reactive airway disease exacerbations (OR, 3.3) (P<.05). None of the other clinical factors were significantly associated with salivagram results. On multivariate analysis, salivagram results were significantly associated with the 4 above-mentioned factors (P = .009). However, these 4 predictive factors were not independent of each other owing to the statistically significant associations among them.


CONCLUSIONS
We identified 4 clinical factors that are predictive of aspiration on salivagram. A high level of suspicion for aspiration should be maintained in children with these potential risk factors.
Simons
Jeffrey P
JP
Department of Otolaryngology, Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine, 3705 Fifth Ave, Pittsburgh, PA 15213, USA.
Rubinstein
Elaine N
EN
Mandell
David L
DL
D000293:Adolescent; D000328:Adult; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D001239:Inhalation; D016015:Logistic Models; D008297:Male; D011015:Pneumonia, Aspiration / Q000000981:diagnostic imaging*; D011237:Predictive Value of Tests; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D012307:Risk Factors; D012463:Saliva / Q000000981:diagnostic imaging*; D013671:Technetium Tc 99m Sulfur Colloid; D014055:Tomography, Emission-Computed / Q000379:methods*
D019275:Radiopharmaceuticals; D013671:Technetium Tc 99m Sulfur Colloid