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Unilateral Vocal Fold Paralysis and Risk of Pneumonia: A Nationwide Population-Based Cohort Study.
Otolaryngol Head Neck Surg. 2018 05; 158(5):896-903.OH

Abstract

Objective To investigate pneumonia risk among patients with unilateral vocal fold paralysis (UVFP). Study Design Retrospective population-based cohort study. Setting This study used data from the National Health Insurance Research Database of Taiwan, a nationwide population-based database. Subjects and Methods A total of 419 patients newly diagnosed with UVFP between January 1, 1997, and December 31, 2013, were identified from the Longitudinal Health Insurance Database 2000, a nationally representative database of 1 million randomly selected patients. Moreover, 1676 patients without UVFP were matched to patients with UVFP at a 1:4 ratio based on age, sex, socioeconomic status, urbanization level, and site-specific cancers. Patients were followed up until death or the end of the study period (December 31, 2013). The primary outcome was the occurrence of pneumonia. Results The cumulative incidence of pneumonia was significantly higher for patients with UVFP than those without UFVP (P < .001). The adjusted Cox proportional hazard model showed that UVFP was significantly associated with a higher incidence of pneumonia (hazard ratio, 1.97; 95% CI, 1.35-2.86; P < .001). Subgroup analyses demonstrated that UVFP was an independent risk factor of pneumonia for 4 subgroups: young (18-50 years), older (≥51 years), male, and cancer. Conclusion This is the first nationwide population-based cohort study to investigate the association between UVFP and pneumonia. The findings indicate that UVFP is an independent risk factor of pneumonia. Given the study results, physicians should be aware of the potential for pneumonia occurrence following UVFP.

Authors+Show Affiliations

1 Department of Otolaryngology-Head and Neck Surgery, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan. 2 Health Information and Epidemiology Laboratory of Chang Gung Memorial Hospital, Chiayi, Taiwan.2 Health Information and Epidemiology Laboratory of Chang Gung Memorial Hospital, Chiayi, Taiwan. 3 Institute of Occupational Medicine and Industrial Hygiene, College of Public Health, National Taiwan University, Taipei, Taiwan. 4 Department of Traditional Chinese Medicine, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan. 5 School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan.2 Health Information and Epidemiology Laboratory of Chang Gung Memorial Hospital, Chiayi, Taiwan.2 Health Information and Epidemiology Laboratory of Chang Gung Memorial Hospital, Chiayi, Taiwan.1 Department of Otolaryngology-Head and Neck Surgery, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan.1 Department of Otolaryngology-Head and Neck Surgery, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan.6 Department of Otolaryngology-Head and Neck Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan. 7 Faculty of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan.8 Division of Pulmonary and Critical Care Medicine, Department of Respiratory Care, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan. 9 Department of Respiratory Therapy, College of Medicine, Chang Gung University, Taoyuan, Taiwan.1 Department of Otolaryngology-Head and Neck Surgery, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan. 5 School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan. 10 Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

29405850

Citation

Tsai, Ming-Shao, et al. "Unilateral Vocal Fold Paralysis and Risk of Pneumonia: a Nationwide Population-Based Cohort Study." Otolaryngology--head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery, vol. 158, no. 5, 2018, pp. 896-903.
Tsai MS, Yang YH, Liu CY, et al. Unilateral Vocal Fold Paralysis and Risk of Pneumonia: A Nationwide Population-Based Cohort Study. Otolaryngol Head Neck Surg. 2018;158(5):896-903.
Tsai, M. S., Yang, Y. H., Liu, C. Y., Lin, M. H., Chang, G. H., Tsai, Y. T., Li, H. Y., Tsai, Y. H., & Hsu, C. M. (2018). Unilateral Vocal Fold Paralysis and Risk of Pneumonia: A Nationwide Population-Based Cohort Study. Otolaryngology--head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery, 158(5), 896-903. https://doi.org/10.1177/0194599818756285
Tsai MS, et al. Unilateral Vocal Fold Paralysis and Risk of Pneumonia: a Nationwide Population-Based Cohort Study. Otolaryngol Head Neck Surg. 2018;158(5):896-903. PubMed PMID: 29405850.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Unilateral Vocal Fold Paralysis and Risk of Pneumonia: A Nationwide Population-Based Cohort Study. AU - Tsai,Ming-Shao, AU - Yang,Yao-Hsu, AU - Liu,Chia-Yen, AU - Lin,Meng-Hung, AU - Chang,Geng-He, AU - Tsai,Yao-Te, AU - Li,Hsueh-Yu, AU - Tsai,Ying-Huang, AU - Hsu,Cheng-Ming, Y1 - 2018/02/06/ PY - 2018/2/7/pubmed PY - 2019/9/21/medline PY - 2018/2/7/entrez KW - aspiration KW - choking KW - dysphagia KW - infection KW - pneumonia KW - risk factor KW - unilateral vocal fold paralysis SP - 896 EP - 903 JF - Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery JO - Otolaryngol Head Neck Surg VL - 158 IS - 5 N2 - Objective To investigate pneumonia risk among patients with unilateral vocal fold paralysis (UVFP). Study Design Retrospective population-based cohort study. Setting This study used data from the National Health Insurance Research Database of Taiwan, a nationwide population-based database. Subjects and Methods A total of 419 patients newly diagnosed with UVFP between January 1, 1997, and December 31, 2013, were identified from the Longitudinal Health Insurance Database 2000, a nationally representative database of 1 million randomly selected patients. Moreover, 1676 patients without UVFP were matched to patients with UVFP at a 1:4 ratio based on age, sex, socioeconomic status, urbanization level, and site-specific cancers. Patients were followed up until death or the end of the study period (December 31, 2013). The primary outcome was the occurrence of pneumonia. Results The cumulative incidence of pneumonia was significantly higher for patients with UVFP than those without UFVP (P < .001). The adjusted Cox proportional hazard model showed that UVFP was significantly associated with a higher incidence of pneumonia (hazard ratio, 1.97; 95% CI, 1.35-2.86; P < .001). Subgroup analyses demonstrated that UVFP was an independent risk factor of pneumonia for 4 subgroups: young (18-50 years), older (≥51 years), male, and cancer. Conclusion This is the first nationwide population-based cohort study to investigate the association between UVFP and pneumonia. The findings indicate that UVFP is an independent risk factor of pneumonia. Given the study results, physicians should be aware of the potential for pneumonia occurrence following UVFP. SN - 1097-6817 UR - https://www.unboundmedicine.com/medline/citation/29405850/Unilateral_Vocal_Fold_Paralysis_and_Risk_of_Pneumonia:_A_Nationwide_Population_Based_Cohort_Study_ L2 - http://journals.sagepub.com/doi/full/10.1177/0194599818756285?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -