Safety and clinical impact of FEES - results of the FEES-registry.
Journal
Neurological research and practice
ISSN: 2524-3489
Titre abrégé: Neurol Res Pract
Pays: England
ID NLM: 101767802
Informations de publication
Date de publication:
2019
2019
Historique:
received:
15
11
2018
accepted:
10
01
2019
entrez:
16
12
2020
pubmed:
26
4
2019
medline:
26
4
2019
Statut:
epublish
Résumé
At present, the flexible endoscopic evaluation of swallowing (FEES) is one of the most commonly used methods for the objective assessment of swallowing. This multicenter trial prospectively collected data on the safety of FEES and also assessed the impact of this procedure on clinical dysphagia management. Patients were recruited in 23 hospitals in Germany and Switzerland from September 2014 to May 2017. Patient characteristics, professional affiliation of the FEES examiners (physicians or speech and language therapists), side-effects and cardiorespiratory parameters, severity of dysphagia and clinical consequences of FEES were documented. 2401 patients, mean age 69.8 (14.6) years, 42.3% women, were included in the FEES-registry. The most common main diagnosis was stroke (61%), followed by Parkinson's disease (6.5%). FEES was well tolerated by patients. Complications were reported in 2% of examinations, were all self-limited and resolved without sequelae and showed no correlation to the endoscopist's previous experience. In more than 50% of investigations FEES led to changes of feeding strategies, in the majority of cases an upgrade of oral diet was possible. This study confirmed that FEES, even when performed by less experienced clinicians is a safe and well tolerated procedure and significantly impacts on the patients' clinical course. Implementation of a FEES-service in different clinical settings may improve dysphagia care. ClinicalTrials.gov NCT03037762, registered January 31st 2017.
Sections du résumé
BACKGROUND
BACKGROUND
At present, the flexible endoscopic evaluation of swallowing (FEES) is one of the most commonly used methods for the objective assessment of swallowing. This multicenter trial prospectively collected data on the safety of FEES and also assessed the impact of this procedure on clinical dysphagia management.
METHODS
METHODS
Patients were recruited in 23 hospitals in Germany and Switzerland from September 2014 to May 2017. Patient characteristics, professional affiliation of the FEES examiners (physicians or speech and language therapists), side-effects and cardiorespiratory parameters, severity of dysphagia and clinical consequences of FEES were documented.
RESULTS
RESULTS
2401 patients, mean age 69.8 (14.6) years, 42.3% women, were included in the FEES-registry. The most common main diagnosis was stroke (61%), followed by Parkinson's disease (6.5%). FEES was well tolerated by patients. Complications were reported in 2% of examinations, were all self-limited and resolved without sequelae and showed no correlation to the endoscopist's previous experience. In more than 50% of investigations FEES led to changes of feeding strategies, in the majority of cases an upgrade of oral diet was possible.
DISCUSSION
CONCLUSIONS
This study confirmed that FEES, even when performed by less experienced clinicians is a safe and well tolerated procedure and significantly impacts on the patients' clinical course. Implementation of a FEES-service in different clinical settings may improve dysphagia care.
TRIAL REGISTRATION
BACKGROUND
ClinicalTrials.gov NCT03037762, registered January 31st 2017.
Identifiants
pubmed: 33324882
doi: 10.1186/s42466-019-0021-5
pii: 21
pmc: PMC7650078
doi:
Banques de données
ClinicalTrials.gov
['NCT03037762']
Types de publication
Journal Article
Langues
eng
Pagination
16Informations de copyright
© The Author(s) 2019.
Références
Neuromuscul Disord. 2009 Oct;19(10):704-8
pubmed: 19616433
J Neurol Neurosurg Psychiatry. 2003 Oct;74(10):1429-31
pubmed: 14570839
Arch Otolaryngol Head Neck Surg. 2010 Aug;136(8):784-9
pubmed: 20713754
Dysphagia. 2018 Feb;33(1):41-50
pubmed: 28828545
Ann N Y Acad Sci. 1987;505:472-99
pubmed: 3318620
Mov Disord. 2010 Jul 15;25(9):1239-45
pubmed: 20629130
Parkinsonism Relat Disord. 2016 Jul;28:100-6
pubmed: 27158122
Dysphagia. 2000 Winter;15(1):39-44
pubmed: 10594257
Crit Care Med. 2013 Jul;41(7):1728-32
pubmed: 23774336
Ann Otol Rhinol Laryngol. 2015 Jul;124(7):537-44
pubmed: 25667217
Dysphagia. 2017 Feb;32(1):78-82
pubmed: 27571768
Stroke. 2009 Feb;40(2):482-6
pubmed: 19074481
Dysphagia. 2004 Summer;19(3):177-81
pubmed: 15383947
Dis Esophagus. 2011 Sep;24(7):476-80
pubmed: 21385285
Dysphagia. 2017 Feb;32(1):27-38
pubmed: 28101663
Arch Phys Med Rehabil. 2005 Aug;86(8):1516-20
pubmed: 16084801
Dysphagia. 2002 Spring;17(2):139-46
pubmed: 11956839
Dysphagia. 1988;2(4):216-9
pubmed: 3251697
J Stroke Cerebrovasc Dis. 2014 Mar;23(3):e195-200
pubmed: 24361193
J Head Trauma Rehabil. 1999 Oct;14(5):448-53
pubmed: 10653940
Intensive Care Med. 2018 Jun;44(6):973-975
pubmed: 29737377
Head Neck. 2013 Jul;35(7):974-9
pubmed: 22730220
J Head Trauma Rehabil. 1999 Oct;14(5):454-61
pubmed: 10653941
Stroke. 2017 May;48(5):1397-1399
pubmed: 28400488
Arch Neurol. 2007 Jan;64(1):58-62
pubmed: 17210809
Dysphagia. 2017 Dec;32(6):725-733
pubmed: 28779300
Laryngoscope. 2003 Jan;113(1):21-4
pubmed: 12514376
Int Disabil Stud. 1988;10(2):64-7
pubmed: 3042746
Neurol Sci. 2015 May;36(5):671-81
pubmed: 25647290
BMC Med Educ. 2016 Feb 25;16:70
pubmed: 26911194
Stroke. 2005 Dec;36(12):2756-63
pubmed: 16269630
Folia Phoniatr Logop. 2016;68(1):37-45
pubmed: 27454127
Am J Respir Crit Care Med. 2002 Nov 15;166(10):1338-44
pubmed: 12421743
Eur Arch Otorhinolaryngol. 2008 Apr;265(4):441-6
pubmed: 17968575
Parkinsonism Relat Disord. 2012 May;18(4):311-5
pubmed: 22137459
Dysphagia. 2016 Oct;31(5):619-25
pubmed: 27384436
Nervenarzt. 2014 Aug;85(8):1006-15
pubmed: 25060752
Curr Gastroenterol Rep. 2005 Jun;7(3):240-3
pubmed: 15913485
Nat Clin Pract Neurol. 2008 Jul;4(7):366-74
pubmed: 18560390
Laryngorhinootologie. 2010 Feb;89(2):90-4
pubmed: 19728257