Clinical Profile of Outpatients Undergoing Swallowing Evaluation and Its Association with Pneumonia History: A...

Background/Objectives: Dysphagia leads to severe complications, but data on patient profiles are limited in Türkiye. In this study, we present swallowing characteristics across etiologies and examine the association between a history of pneumonia and videofluoroscopic swallowing study (VFSS) findings. Methods: This retrospective study included 1055 adults, comprising a large, heterogeneous outpatient population, referred for swallowing evaluation between 2015 and 2018. Clinical data (demographics, diagnoses, feeding status, etc.) and VFSS findings (Penetration-Aspiration Scale, PAS; pharyngeal residue) for liquid and semisolid consistencies were recorded from our electronic database. Associations were initially assessed using the chi-square test. A logistic regression analysis was performed to identify factors associated with pneumonia history. Results: Neurologic diseases (62.1%) were the most frequent diagnosis. VFSS identified liquid aspiration in 53.9% (61.8% silent) and semisolid aspiration in 20.1% (72.5% silent) of patients. Pharyngeal residue occurred in up to 10.6% of patients for liquids and 24.3% for semisolids. Diet recommendations were modified for 43.3% of patients (p < 0.05). Overall, 26.6% of patients had a history of pneumonia. In unadjusted, exploratory comparisons, pneumonia history was significantly associated with higher frequencies of aspiration and silent aspiration (p < 0.001), while pharyngeal residue was comparable between groups (p > 0.05). Multivariable logistic regression analysis showed that nonsilent aspiration (PAS 6-7) and silent aspiration (PAS 8) were associated with pneumonia history in both liquid (OR = 2.18 and 3.06) and semisolid consistencies (OR = 2.32 and 3.71), and that pharyngeal residue in semisolid consistency was also associated with pneumonia history (OR = 1.57). Conclusions: This study provides a comprehensive clinical profile of dysphagia in Türkiye, highlighting high rates of silent aspiration and the role of instrumental assessment in guiding safe feeding. While a significant association was observed between pneumonia history and impaired swallowing safety and efficiency, the retrospective nature of this study precludes causal interpretations.