老年髋部骨折患者口腔虚弱指数-8临界值与吞咽困难的关系：一项回顾性队列研究

IF 4 3区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of oral rehabilitation Pub Date : 2025-10-04 DOI:10.1111/joor.70072

Yoshihiro Watanabe, Yoichi Sato, Toshiaki Tamura, Ryota Imai, Takafumi Abe, Takayuki Kuwabara, Koki Maruyama, Takao Wakai, Shinya Ibuchi, Hirokazu Ashiga, Masako Fujiu-Kurachi

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引用次数: 0

摘要

背景：老年髋部骨折患者中常见的吞咽困难的早期检测具有挑战性。口腔虚弱，反映了与年龄相关的口腔功能下降，可以作为吞咽困难风险的早期指标。目的：通过口腔虚弱指数-8 （OFI-8）评估术前口腔虚弱是否与吞咽困难相关，并确定预测吞咽困难的最佳OFI-8临界值。方法：这项单中心回顾性队列研究纳入了130例≥65岁的髋部骨折患者。术前使用OFI-8评估口腔虚弱。出院时吞咽困难定义为功能性口腔摄入量表评分≤5分。采用Firth惩罚似然法进行Logistic回归分析，评估吞咽困难风险与口腔虚弱状态（存在/不存在）和OFI-8评分之间的关系。采用受试者工作特征（ROC）分析确定最佳OFI-8截止点。结果：10.0%（13/130）患者出现吞咽困难。没有口腔虚弱的患者没有出现吞咽困难，而有口腔虚弱的患者有13.8%出现吞咽困难（p = 0.019）。较高的OFI-8评分与吞咽困难风险增加显著相关（优势比= 1.81；95%可信区间[CI]: 1.27-2.98; p）结论：较高的OFI-8评分和严重的口腔虚弱与吞咽困难风险独立相关。

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Relationship Between Oral Frailty Index-8 Cutoff Values and Dysphagia in Older Patients With Hip Fracture: A Retrospective Cohort Study.

Background: Early detection of dysphagia, which is frequent in older patients with hip fractures, is challenging. Oral frailty, reflecting age-related decline in oral function, may serve as an early indicator of dysphagia risk.

Objectives: To evaluate whether preoperative oral frailty, assessed by the Oral Frailty Index-8 (OFI-8), is associated with dysphagia and to determine the optimal OFI-8 cutoff for predicting it.

Methods: This single-centre retrospective cohort study included 130 patients ≥ 65 years with hip fractures. Preoperative oral frailty was assessed using OFI-8. Dysphagia at discharge was defined as a Functional Oral Intake Scale score ≤ 5. Logistic regression analysis with Firth's penalised likelihood method was performed to evaluate associations between dysphagia risk and both oral frailty status (present/absent) and OFI-8 scores. Receiver operating characteristic (ROC) analysis was conducted to determine the optimal OFI-8 cutoff.

Results: Dysphagia was observed in 10.0% (13/130) of the patients. None of the patients without oral frailty developed dysphagia, whereas 13.8% of those with oral frailty did (p = 0.019). Higher OFI-8 scores were significantly associated with increased dysphagia risk (odds ratio = 1.81; 95% confidence interval [CI]: 1.27-2.98; p < 0.001). ROC analysis identified an OFI-8 cutoff of 7, with an area under the curve of 0.886, sensitivity 92.3%, and specificity 72.6%. Severe oral frailty (OFI-8 ≥ 7) was strongly associated with dysphagia (odds ratio = 13.35; 95% CI: 2.80-130.87; p < 0.001).

Conclusion: Higher OFI-8 scores and severe oral frailty are independently associated with dysphagia risk.

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来源期刊

Journal of oral rehabilitation 医学-牙科与口腔外科

CiteScore

5.60

自引率

10.30%

发文量

116

审稿时长

4-8 weeks

期刊介绍： Journal of Oral Rehabilitation aims to be the most prestigious journal of dental research within all aspects of oral rehabilitation and applied oral physiology. It covers all diagnostic and clinical management aspects necessary to re-establish a subjective and objective harmonious oral function. Oral rehabilitation may become necessary as a result of developmental or acquired disturbances in the orofacial region, orofacial traumas, or a variety of dental and oral diseases (primarily dental caries and periodontal diseases) and orofacial pain conditions. As such, oral rehabilitation in the twenty-first century is a matter of skilful diagnosis and minimal, appropriate intervention, the nature of which is intimately linked to a profound knowledge of oral physiology, oral biology, and dental and oral pathology. The scientific content of the journal therefore strives to reflect the best of evidence-based clinical dentistry. Modern clinical management should be based on solid scientific evidence gathered about diagnostic procedures and the properties and efficacy of the chosen intervention (e.g. material science, biological, toxicological, pharmacological or psychological aspects). The content of the journal also reflects documentation of the possible side-effects of rehabilitation, and includes prognostic perspectives of the treatment modalities chosen.