Silent aspiration lacks clinical manifestations and easily leads to complications such as aspiration pneumonia. At present, there is a lack of research on the current status of silent aspiration and its influencing factors in patients with dysphagia in China.

To understand the current status of silent aspiration among patients with dysphagia in China and to explore the influencing factors of silent aspiration.

This study was a cross-sectional survey. 212 patients with dysphagia were selected as study subjects among the rehabilitation, neurosurgery, and neurology departments of four hospitals in Nanjing (the First Affiliated Hospital with Nanjing Medical University, the Affiliated Jiangning Hospital of Nanjing Medical University, the Affiliated Sir Run Run Hospital of Nanjing Medical University, and the Dongshan Hospital of Jiangning District of Nanjing) by the convenience sampling method from December 2022 to January 2024. The basic data of the patients were recorded, and the Eating Assessment Questionnaire (EAT-10) score and Barthel Index were used to assess dysphagia risk and ability to perform activities of daily living. Fluoroscopic Fluorescence Swallowing Screening (VFSS) or Flexible Endoscopic Swallowing Function Examination (FEES) was used to diagnose whether the patient experienced aspiration and the type of aspiration. In this study, all patients who had no aspiration during swallowing were categorized as the no aspiration group, all patients who had at least 1 silent aspiration during swallowing were categorized as the silent aspiration group, and all patients who had at least 1 overt aspiration but no silent aspiration during swallowing were categorized as the overt aspiration group. Multivariate Logistic regression analysis was used to explore the influencing factors of silent aspiration and overt aspiration.

Silent aspiration accounted for 47.2% (100/212), overt aspiration 13.2% (28/212), and no aspiration 39.6% (84/212) of patients with dysphagia. Among the 128 patients with aspiration, 78.1% (100/128) were silent aspiration and 21.9% (28/128) were overt aspiration. The results of multivariate Logistic regression analysis showed that the EAT-10 score (OR=1.076, 95%CI=1.028-1.126, P=0.002), gender (female as control, OR=2.231, 95%CI=1.103-4.509, P=0.025), and conscious status (impaired consciousness as control, OR=0.334, 95%CI=0.123-0.911, P=0.032) were influential factors for silent aspiration. EAT-10 scores (OR=1.113, 95%CI=1.046-1.184, P=0.001) and poor self-assessed health (OR=0.194, 95%CI=0.041-0.923, P=0.039) were influential factors for overt aspiration.

The prevalence of silent aspiration is higher among patients with dysphagia and the risk of silent aspiration increases with higher EAT-10 scores, in males, and in those with impaired consciousness.

隐性误吸缺乏临床表现，易导致误吸性肺炎等并发症，而目前国内吞咽障碍患者隐性误吸发生现状及其影响因素相关研究较为缺乏。

了解国内吞咽障碍患者中隐性误吸的现状，探究隐性误吸的影响因素。

本研究为横断面调查。于2022年12月—2024年1月通过便利抽样法在南京市4所医院（南京医科大学第一附属医院、南京医科大学附属江宁医院、南京医科大学附属逸夫医院和南京市江宁区东山医院）康复科、神经外科、神经内科的吞咽障碍患者中选取212例作为研究对象。记录患者的基本资料，并采用进食评估问卷调查（EAT-10）得分和Barthel指数评估吞咽困难风险和日常生活活动能力。采用透视荧光吞咽检查（VFSS）或软式喉内窥镜吞咽功能检查（FEES）诊断患者是否误吸以及误吸的类型。本研究将所有吞咽过程中均没有发生误吸的患者归为无误吸组，所有吞咽过程中出现至少1次隐性误吸的患者归为隐性误吸组，所有吞咽过程中出现至少1次显性误吸但未出现隐性误吸的患者归为显性误吸组。采用多因素Logistic回归分析探讨隐性误吸和显性误吸的影响因素。

吞咽障碍患者中隐性误吸占47.2%（100/212）、显性误吸占13.2%（28/212）、无误吸占39.6%（84/212）。在128例误吸患者中，隐性误吸占78.1%（100/128），显性误吸占21.9%（28/128）。多因素Logistic回归分析结果显示，EAT-10得分（OR=1.076，95%CI=1.028~1.126，P=0.002）、性别（女性为对照，OR=2.231，95%CI=1.103~4.509，P=0.025）和意识状况（意识受损为对照，OR=0.334，95%CI=0.123~0.911，P=0.032）是隐性误吸的影响因素；EAT-10得分（OR=1.113，95%CI=1.046~1.184，P=0.001）和自评健康状况差（OR=0.194，95%CI=0.041~0.923，P=0.039）是显性误吸的影响因素。

吞咽障碍患者中隐性误吸发生率较高，且EAT-10得分越高、男性和意识受损者发生隐性误吸的风险高。