舌压是肌萎缩性脊髓侧索硬化症患者是否建议进行胃造瘘术的重要预测因素。

IF 2.8 3区 医学 Q2 CLINICAL NEUROLOGY
Muscle & Nerve Pub Date : 2024-09-01 Epub Date: 2024-06-18 DOI:10.1002/mus.28174
Amanda E Mendes, Guilherme D Silva, Frederico M H Jorge, Dagoberto Callegaro
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引用次数: 0

摘要

导言/目的:目前尚缺乏客观实用的生物标志物来确定肌萎缩侧索硬化症(ALS)患者是否需要进行胃造瘘术。舌压(TP)是一种很有前景的生物标志物,因为它与球部功能障碍有关。本研究旨在评估 TP 与胃造口术需求的相关性,并确定其最佳临界值:这项前瞻性观察研究纳入了口服营养的 ALS 患者。采用爱荷华州口腔表现工具对TP进行评估。记录多学科团队在 12 个月随访期间确定的胃造瘘需求。进行了 TP 与胃造口术安置需求之间的关联分析。ROC 曲线分析确定了预测胃造瘘的最佳 TP 临界值:在 208 名经过筛选的参与者中,有 119 人被纳入。在为期 12 个月的随访中,45% 的患者(53 人)需要进行胃造瘘术。TP≤20kPA是胃造瘘指征的有力预测指标(OR 11.8,CI 95% [4.61,34.7],P 讨论):TP是ALS患者随后12个月内胃切除术指征的一个强有力的独立预测因子,在临界值≤20 kPA时具有良好的灵敏度和特异性,这表明它可能是临床实践中一个很有前途的生物标志物。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Tongue pressure is a strong predictor of recommendation for gastrostomy in amyotrophic lateral sclerosis.

Introduction/aims: Objective and practical biomarkers to determine the need for gastrostomy in patients with amyotrophic lateral sclerosis (ALS) are lacking. Tongue pressure (TP) is a promising biomarker because it is associated with bulbar dysfunction. The aims of this study were to evaluate the association of TP with the need for gastrostomy, and to determine its optimal cut-off value.

Methods: This prospective observational study included participants with ALS taking nutrition orally. TP was evaluated using the Iowa Oral Performance Instrument. Need for gastrostomy as determined by a multidisciplinary team during a 12-month follow up period was recorded. Associations between TP and need for gastrostomy placement were performed. ROC curve analysis determined the optimal cut-off value of TP to predict gastrostomy.

Results: Of 208 screened participants, 119 were included. Gastrostomy was indicated in 45% (53), in a 12-month follow up period. TP of ≤20 kPA was a strong predictor of gastrostomy indication (OR 11.8, CI 95% [4.61, 34.7], p < .001). The association persisted even after adjustment for weight loss, pneumonia, prolonged feeding duration, Revised ALS Functional Rating Scale score, and American Speech-Language-Hearing Association scale score (OR 4.51, CI 95% [1.50, 14.9], p = .009). By receiver operating characteristic curve analysis, 20 kPA represented the optimal cut-off value (sensitivity 0.75, specificity 0.89).

Discussion: TP is a strong independent predictor of gastrostomy indication in the subsequent 12 months in patients with ALS, with good sensitivity and specificity at a cutoff value of ≤20 kPA, suggesting that it may be a promising biomarker in clinical practice.

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来源期刊
Muscle & Nerve
Muscle & Nerve 医学-临床神经学
CiteScore
6.40
自引率
5.90%
发文量
287
审稿时长
3-6 weeks
期刊介绍: Muscle & Nerve is an international and interdisciplinary publication of original contributions, in both health and disease, concerning studies of the muscle, the neuromuscular junction, the peripheral motor, sensory and autonomic neurons, and the central nervous system where the behavior of the peripheral nervous system is clarified. Appearing monthly, Muscle & Nerve publishes clinical studies and clinically relevant research reports in the fields of anatomy, biochemistry, cell biology, electrophysiology and electrodiagnosis, epidemiology, genetics, immunology, pathology, pharmacology, physiology, toxicology, and virology. The Journal welcomes articles and reports on basic clinical electrophysiology and electrodiagnosis. We expedite some papers dealing with timely topics to keep up with the fast-moving pace of science, based on the referees'' recommendation.
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