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Dysphagia in Thoracic Surgical Patients

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ClinicalTrials.gov Identifier: NCT04487028
Recruitment Status : Recruiting
First Posted : July 27, 2020
Last Update Posted : November 19, 2020
Sponsor:
Information provided by (Responsible Party):
University of Florida

Brief Summary:
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.

Condition or disease Intervention/treatment
Thoracic Diseases Procedure: Fiberoptic Endoscopic Evaluation of Swallowing

Detailed Description:
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

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Study Type : Observational
Estimated Enrollment : 240 participants
Observational Model: Cohort
Time Perspective: Prospective
Official Title: Dysphagia in Thoracic Surgical Patients: Incidence, Risk-factors, and Health Related Outcomes
Actual Study Start Date : August 25, 2020
Estimated Primary Completion Date : January 2022
Estimated Study Completion Date : August 2022

Resource links provided by the National Library of Medicine


Group/Cohort Intervention/treatment
Thoracic Surgical Patients
Participants will undergo a Fiberoptic Endoscopic Evaluation of Swallowing (FEES)
Procedure: Fiberoptic Endoscopic Evaluation of Swallowing
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.
Other Name: FEES




Primary Outcome Measures :
  1. Penetration Aspiration Scale [ Time Frame: Baseline ]
    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.


Secondary Outcome Measures :
  1. Yale Residue Severity Rating Scale [ Time Frame: Baseline ]
    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).


Other Outcome Measures:
  1. Vocal Fold Mobility Impairment [ Time Frame: Baseline ]
    During a Fiberoptic Endoscopic Evaluation of Swallowing (FEES), the vocal folds will be visualized using a small camera passed through the open nasal passage. The patient will be asked to make a series of vocal tasks so that we can visualize their movement, any immobility will be notated.



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Ages Eligible for Study:   18 Years to 90 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Sampling Method:   Non-Probability Sample
Study Population
240 individuals undergoing thoracic surgery will be enrolled in this study.
Criteria

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.

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT04487028


Contacts
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Contact: Amber R Anderson, MS 352-237-8632 amber.anderson@phhp.ufl.edu

Locations
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United States, Florida
Cardiovascular Clinic at UF Health UF Recruiting
Gainesville, Florida, United States, 32610
Thoracic and Cardiovasscular Surgery at UF Health Recruiting
Gainesville, Florida, United States, 32610
UF Health at the University of Florida Recruiting
Gainesville, Florida, United States, 32610
Sponsors and Collaborators
University of Florida
Investigators
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Principal Investigator: Emily K Plowman, PhD University of Florida
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Responsible Party: University of Florida
ClinicalTrials.gov Identifier: NCT04487028    
Other Study ID Numbers: IRB202000724-A
First Posted: July 27, 2020    Key Record Dates
Last Update Posted: November 19, 2020
Last Verified: November 2020
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No

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Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No
Keywords provided by University of Florida:
Dysphagia
Extubation
Vocal Fold Mobility Impairment
Peak Cough Flow (PCF)
Additional relevant MeSH terms:
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Deglutition Disorders
Thoracic Diseases
Esophageal Diseases
Gastrointestinal Diseases
Digestive System Diseases
Pharyngeal Diseases
Otorhinolaryngologic Diseases
Respiratory Tract Diseases