{"title":"通过入院后 24 小时内的早期吞咽功能评估预测出院时的口腔摄入量:回顾性队列研究","authors":"Daisuke Matsuura, Yohei Otaka, Saki Asaumi, Tomomi Itano, Tetsushi Chikamoto, Shigeru Yamori, Yusuke Murakami","doi":"10.1007/s00455-024-10699-x","DOIUrl":null,"url":null,"abstract":"<p><p>Dysphagia is one of the most common symptoms of stroke and can lead to other complications such as pneumonia, dehydration, and malnutrition. This retrospective cohort study evaluated the predictive value of a comprehensive swallowing assessment tool, the Mann Assessment of Swallowing Ability (MASA), in the acute phase of stroke for oral intake status at discharge. Among 1,133 consecutive patients with acute stroke, 512 patients whose swallowing function was assessed using the MASA within 24 h of admission were included. Data including demographic information, stroke severity, MASA, Oral Health Assessment Tool, body mass index, and serum albumin level were collected. Predictive factors for oral intake were analyzed using a multiple logistic regression model, and the receiver operating characteristic (ROC) curve analysis was used to determine the cutoff values of the MASA score for determining oral intake at discharge. Oral intake at discharge was established in 69.1% of the cohort (354/512). The multiple logistic regression analysis identified a higher MASA score, younger age, and higher serum albumin level as significant predictors of oral intake at discharge. The cutoff value of the MASA score for oral intake was 136.5 points, with an area under the ROC curve of 0.87. These findings suggest that the MASA is a valid tool for predicting oral intake in patients with dysphagia during the acute phase of stroke.</p>","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":"1163-1170"},"PeriodicalIF":2.2000,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11607090/pdf/","citationCount":"0","resultStr":"{\"title\":\"Prediction of Oral Intake at Discharge with Early Assessment of Swallowing Function within 24 h after Admission: A Retrospective Cohort Study.\",\"authors\":\"Daisuke Matsuura, Yohei Otaka, Saki Asaumi, Tomomi Itano, Tetsushi Chikamoto, Shigeru Yamori, Yusuke Murakami\",\"doi\":\"10.1007/s00455-024-10699-x\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Dysphagia is one of the most common symptoms of stroke and can lead to other complications such as pneumonia, dehydration, and malnutrition. This retrospective cohort study evaluated the predictive value of a comprehensive swallowing assessment tool, the Mann Assessment of Swallowing Ability (MASA), in the acute phase of stroke for oral intake status at discharge. Among 1,133 consecutive patients with acute stroke, 512 patients whose swallowing function was assessed using the MASA within 24 h of admission were included. Data including demographic information, stroke severity, MASA, Oral Health Assessment Tool, body mass index, and serum albumin level were collected. Predictive factors for oral intake were analyzed using a multiple logistic regression model, and the receiver operating characteristic (ROC) curve analysis was used to determine the cutoff values of the MASA score for determining oral intake at discharge. Oral intake at discharge was established in 69.1% of the cohort (354/512). The multiple logistic regression analysis identified a higher MASA score, younger age, and higher serum albumin level as significant predictors of oral intake at discharge. The cutoff value of the MASA score for oral intake was 136.5 points, with an area under the ROC curve of 0.87. These findings suggest that the MASA is a valid tool for predicting oral intake in patients with dysphagia during the acute phase of stroke.</p>\",\"PeriodicalId\":11508,\"journal\":{\"name\":\"Dysphagia\",\"volume\":\" \",\"pages\":\"1163-1170\"},\"PeriodicalIF\":2.2000,\"publicationDate\":\"2024-12-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11607090/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Dysphagia\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s00455-024-10699-x\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/4/1 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q1\",\"JCRName\":\"OTORHINOLARYNGOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Dysphagia","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00455-024-10699-x","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/4/1 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"OTORHINOLARYNGOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
吞咽困难是中风最常见的症状之一,可导致肺炎、脱水和营养不良等其他并发症。这项回顾性队列研究评估了中风急性期综合吞咽评估工具曼氏吞咽能力评估(MASA)对出院时口腔摄入状况的预测价值。在 1,133 名连续的急性脑卒中患者中,纳入了 512 名在入院 24 小时内使用 MASA 评估过吞咽功能的患者。收集的数据包括人口统计学信息、中风严重程度、MASA、口腔健康评估工具、体重指数和血清白蛋白水平。采用多元逻辑回归模型分析了口腔摄入量的预测因素,并通过接收者操作特征曲线(ROC)分析确定了用于确定出院时口腔摄入量的 MASA 评分临界值。69.1%的患者(354/512)在出院时确定了口腔摄入量。多元逻辑回归分析表明,较高的 MASA 评分、较年轻的年龄和较高的血清白蛋白水平是出院时口腔摄入量的重要预测因素。口腔摄入量的 MASA 评分临界值为 136.5 分,ROC 曲线下面积为 0.87。这些研究结果表明,MASA 是预测卒中急性期吞咽困难患者口腔摄入量的有效工具。
Prediction of Oral Intake at Discharge with Early Assessment of Swallowing Function within 24 h after Admission: A Retrospective Cohort Study.
Dysphagia is one of the most common symptoms of stroke and can lead to other complications such as pneumonia, dehydration, and malnutrition. This retrospective cohort study evaluated the predictive value of a comprehensive swallowing assessment tool, the Mann Assessment of Swallowing Ability (MASA), in the acute phase of stroke for oral intake status at discharge. Among 1,133 consecutive patients with acute stroke, 512 patients whose swallowing function was assessed using the MASA within 24 h of admission were included. Data including demographic information, stroke severity, MASA, Oral Health Assessment Tool, body mass index, and serum albumin level were collected. Predictive factors for oral intake were analyzed using a multiple logistic regression model, and the receiver operating characteristic (ROC) curve analysis was used to determine the cutoff values of the MASA score for determining oral intake at discharge. Oral intake at discharge was established in 69.1% of the cohort (354/512). The multiple logistic regression analysis identified a higher MASA score, younger age, and higher serum albumin level as significant predictors of oral intake at discharge. The cutoff value of the MASA score for oral intake was 136.5 points, with an area under the ROC curve of 0.87. These findings suggest that the MASA is a valid tool for predicting oral intake in patients with dysphagia during the acute phase of stroke.
期刊介绍:
Dysphagia aims to serve as a voice for the benefit of the patient. The journal is devoted exclusively to swallowing and its disorders. The purpose of the journal is to provide a source of information to the flourishing dysphagia community. Over the past years, the field of dysphagia has grown rapidly, and the community of dysphagia researchers have galvanized with ambition to represent dysphagia patients. In addition to covering a myriad of disciplines in medicine and speech pathology, the following topics are also covered, but are not limited to: bio-engineering, deglutition, esophageal motility, immunology, and neuro-gastroenterology. The journal aims to foster a growing need for further dysphagia investigation, to disseminate knowledge through research, and to stimulate communication among interested professionals. The journal publishes original papers, technical and instrumental notes, letters to the editor, and review articles.