title: Contrast pooling in videofluoroscopic swallowing study as a risk factor for pneumonia in children with dysphagia.
abstract: OBJECTIVE
  To determine if laryngeal contrast pooling on a videofluoroscopic swallowing study increases the risk for pneumonia in the following 6 months in children with dysphagia. Secondarily, to determine in the same population, if laryngeal abnormalities or syndromic disorders increase the risk for pneumonia in the same timeframe.
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  A chart review of pediatric patients that presented to the swallowing and dysphagia clinic at the Montreal Children's Hospital for a videofluoroscopic swallowing study in the last three years was conducted. Videofluoroscopic findings, patient characteristics, demographic data, and pneumonias occurring within 6 months after the study were recorded for all patients. Patients with unsuccessful swallowing studies, incomplete charts, extra-laryngeal etiologies for recurrent pneumonia, or who were lost to follow up were excluded.
  
  
  RESULTS
  Of the 287 children who presented to the clinic, 239 patients remained after exclusion, of which 40 (16.7%) exhibited pooling and 199 (83.3%) did not. Children with pooling on videofluoroscopic swallowing study did not have significantly more pneumonias than patients without pooling (22.5% vs 17.1%, P=0.42). Secondary analyses revealed that laryngeal abnormalities were a significant independent risk factor (P=0.02) for pneumonia at 6 months, while being diagnosed with a syndrome was not (P=0.18).
  
  
  CONCLUSIONS
  In this study of contrast pooling in videofluoroscopic swallowing study, there was no significant difference in pneumonia occurrence in patients with and without pooling at 6 months post study. Future prospective studies should be conducted to confirm these findings. The present review showed that feeding changes should not be made based on pooling alone.
authors.affiliation: Radboud University Nijmegen, Nijmegen, Netherlands; Department of Otolaryngology Head & Neck Surgery, The Montreal Children's Hospital, Montréal, QC, Canada.
authors.forename: Glen
authors.initials: G
authors.lastname: Kemps
authors.affiliation: Division of Clinical Epidemiology, McGill University Health Centre, Montréal, QC, Canada.
authors.forename: Maida
authors.initials: M
authors.lastname: Sewitch
authors.affiliation: Department of Occupational Therapy, The Montreal Children's Hospital, Montréal, QC, Canada.
authors.forename: Rena
authors.initials: R
authors.lastname: Birnbaum
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, McGill University, The Montreal Children's Hospital, Montréal, QC, Canada. Electronic address: sam.daniel@mcgill.ca.
authors.forename: Sam J
authors.initials: SJ
authors.lastname: Daniel
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D002933:Cineradiography; D003287:Contrast Media; D003679:Deglutition / Q000502:physiology*; D003680:Deglutition Disorders / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007830:Larynx / Q000002:abnormalities / Q000000981:diagnostic imaging; D008297:Male; D011014:Pneumonia / Q000209:etiology*; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors
chemical_list: D003287:Contrast Media
keywords: Laryngeal contrast pooling; Pediatric; Pneumonia; Videofluoroscopic swallowing study