Identification of a simple screening tool for dysphagia in patients with stroke using factor analysis of multiple dysphagia variables
Identification of a simple screening tool for dysphagia in patients with stroke using factor analysis of multiple dysphagia variables
复制标题
DOI：
10.1080/16501970510026999
复制
发表时间：
2005-07-01
影响因子：
3.5
通讯作者：
Fujiwara, T
中科院分区：
文献类型：
--
作者：
Nishiwaki, K;Tsuji, T;Fujiwara, T
目的：确定一个最有用和最简单的临床筛选工具来预测脑卒中患者的电视透视误吸。设计：多个吞咽困难变量的因子分析和卡方检验的敏感性和特异性检验。患者：61名连续脑卒中患者，症状提示吞咽困难，在日本的一所大学医院及其4家附属医院住院。方法：从6项骨科检查中提取因子，（嘴唇闭合、舌运动、腭部抬高、咽反射、嗓音质量和运动言语功能），2次吞咽筛查（唾液吞咽试验和我们使用30 ml水的改良的水吞咽试验）和用视频荧光透视吞咽研究评价的4个参数。每个吞咽困难相关变量的敏感性和特异性确定对吸入在videofluoroscopic吞咽study.Results：因子分析显示，咳嗽/声音的变化，在水吞咽试验和吸入videofluoroscopic吞咽研究属于同一个因素。卡方分析显示，吞咽水试验中咳嗽/声音变化是与电视透视吞咽研究中误吸显著相关的唯一变量，其作为误吸预测因子的敏感性为72%（95%CI：61-83%），特异性为67%（CI：55-79%）（p <0.05）。
Objective: To identify a most useful and simple clinical screening tool to predict videofluoroscopic aspiration in patients with stroke.Design: Factor analysis of multiple dysphagia variables and sensitivity and specificity testing with chi-square test.Patients: Sixty-one consecutive stroke patients with symptoms suggestive of dysphagia admitted to a university hospital and its 4 affiliated hospitals in Japan.Methods: Factors were extracted from 6 oromotor examinations (lip closure, tongue movement, palatal elevation, gag reflex, voice quality and motor speech function), 2 swallow screen tests (saliva swallowing test and our modified water swallowing test using 30 ml of water) and 4 parameters evaluated with a videofluoroscopic swallow study. Sensitivity and specificity of each dysphagia-related variable was determined against aspiration in a videofluoroscopic swallow study.Results: Factor analysis revealed that cough/voice change in the water swallowing test and aspiration on videofluoroscopic swallow study belonged to the same factor. Chi-square analysis showed that cough/voice change in the water swallowing test was the only variable that was significantly associated with aspiration on videofluoroscopic swallow study, with a sensitivity of 72% (95% CI: 61-83%) and a specificity of 67% (CI:55-79%) as a predictor of aspiration (p