A Predictive Model for Oral Intake Independence in Dysphagia Treatment.

Abstract

Objective: One concern for patients suffering from dysphagia is whether their swallowing improves enough to allow oral intake. Predicting oral intake independence would be practical for deciding the treatment strategy, such as swallowing improvement surgeries, at an early stage. This study describes the prognostic factors and predictive method for achieving oral intake independence at discharge from acute care hospitals.

Methods: A total of 128 patients managed by the dysphagia treatment team were retrospectively examined. They were divided into two groups: the independent oral intake group and the restricted oral intake group. The patients' age, sex, causes of dysphagia, calf circumference (CC), body mass index (BMI), Hyodo score obtained through flexible endoscopic evaluation, Food Intake Level Scale (FILS) score, and Dysphasia Severity Scale (DSS) score at the initial consultation were determined.

Results: The independent group had 32 patients, whereas the restricted group had 96 patients. The independent group had higher CC, BMI, and number of dysphagia cases caused by stroke. This group also had lower Hyodo scores and higher DSS scores. Multiple logistic regression analysis revealed that the Hyodo score and CC were independent prognostic factors for oral intake independence. Moreover, the prediction model developed using both factors showed relatively high accuracy (sensitivity: 42.9%, specificity: 94.0%, predictive accuracy: 81.3%).

Conclusion: A lower Hyodo score and higher CC at the initial consultation may be positive prognostic factors for achieving oral intake independence. The predictive model exhibited high accuracy, indicating it may help in determining alternative treatment strategies for serious dysphagia patients.

Level of evidence: Level 3 Laryngoscope, 2024.