Cough peak flow as a predictor of pulmonary morbidity in patients with dysphagia

Carlo Bianchi, Paola Baiardi, Sonia Khirani, Giovanna Cantarella

Research output: Contribution to journalArticlepeer-review


OBJECTIVE: The aim of this study was to ascertain whether an objective cough measure relates to the risk of pulmonary complications in dysphagic patients with persistent tracheobronchial aspiration. DESIGN: This is a retrospective observational study involving 55 dysphagic patients who underwent a modified barium swallow study and pulmonary function tests including cough peak flow measurement. The results were compared between subjects with and without pulmonary complications because of aspiration. RESULTS: The 18 patients (33%) with pulmonary complications had significantly lower mean cough peak flow values (202.2 ± 68.8 vs. 303.9 ± 80.7 liters/min; P <0.001) than those without pulmonary complications. The finding of tracheobronchial coating in a modified barium swallow was not related to the occurrence of pulmonary morbidity. Receiver operating characteristic curve analysis showed that a CPF level lower than 242 liters/min predicted the development of pulmonary complications with a sensitivity of 77% and a specificity of 83%; the positive and negative predictive values were 65% and 90%, respectively. CONCLUSIONS: Our findings indicate that cough peak flow is a valuable predictor of respiratory prognosis in chronic aspiration. This finding suggests a new rehabilitation strategy aimed at improving cough flows for dysphagic patients.

Original languageEnglish
Pages (from-to)783-788
Number of pages6
JournalAmerican Journal of Physical Medicine and Rehabilitation
Issue number9
Publication statusPublished - Sep 2012


  • Aspiration
  • Aspiration Pneumonia
  • Cough Efficacy
  • Deglutition
  • Deglutition Disorders
  • Respiratory Prognosis
  • Voluntary Cough

ASJC Scopus subject areas

  • Rehabilitation
  • Physical Therapy, Sports Therapy and Rehabilitation
  • Medicine(all)

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