Relationship between the Functional Independence Measure and Mann Assessment of Swallowing Ability in hospitalized patients with pneumonia
Relationship between the Functional Independence Measure and Mann Assessment of Swallowing Ability in hospitalized patients with pneumonia
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DOI：
10.1111/ggi.13543
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发表时间：
2018-12-01
影响因子：
3.3
通讯作者：
Ishikawa, Akira
中科院分区：
文献类型：
--
作者：
Mitani, Yuji;Oki, Yutaro;Ishikawa, Akira
目的肺炎在全球死亡原因中排名靠前。然而，日常生活活动能力，营养指数和愿望指数客观测量的预测价值仍然不清楚。本研究旨在探讨活动、营养和吞咽困难与肺炎的关系。方法对992例住院患者进行调查。Logistic回归分析用于检查肺炎的预测因素。采用受试者工作特征曲线分析确定变量的截断值。Kaplan-Meier和考克斯风险回归分析用于检查肺炎的发生率和与肺炎相关的因素。结果最终纳入住院患者393例。393例患者中，102例（26.0%）患有肺炎。Logistic回归分析显示，年龄、功能独立性测量（FINS）-运动评分和Mann吞咽能力评估（MASA）评分是肺炎的独立预测因子。FIM运动和MASA的截止值分别为19.5（曲线下面积0.83，P < 0.01）和170.5（曲线下面积0.82，P < 0.01）。Kaplan-Meier分析显示，FIM运动评分= 20分的患者无肺炎发生率显著较低（log-rank检验，P < 0.01），MASA评分= 171分的患者无肺炎发生率显著较低（log-rank检验，P < 0.01）。考克斯回归分析显示，FIM运动评分（hazardratio 0.97，P = 0.009）和MASA评分（hazardratio 0.99，P < 0.01）与肺炎有显著相关性。结论除了感染风险外，FIM运动和MASA量表是预测老年人肺炎发展的有用工具。Geriatr Gerontol Int 2018; 18：1620-1624.
Aim Pneumonia ranks high among the causes of death worldwide. However, the predictive values of activities of daily living, the nutrition index and the aspiration index measured objectively remain unclear. The present study aimed to examine the associations of activity, nutrition and dysphagia with pneumonia. Methods We assessed 992 hospitalized patients. Logistic regression analysis was used to examine the predictors of pneumonia. Receiver operating characteristic curve analysis was used to determine the cut-off values of variables. Kaplan-Meier and Cox hazards regression analyses were used to examine the incidence of pneumonia and the factors associated with pneumonia. Results We finally enrolled 393 inpatients. Of the 393 patients, 102 (26.0%) had pneumonia. On logistic regression analysis, age, Functional Independence Measure (FIM)-motor score and Mann Assessment of Swallowing Ability (MASA) score were independent predictors of pneumonia. The FIM-motor and MASA cut-off values were 19.5 (area under the curve 0.83, P < 0.01) and 170.5 (area under the curve 0.82, P < 0.01), respectively. Kaplan-Meier analysis showed that the no pneumonia rate was significantly lower among patients with FIM-motor scores = 20 (log-rank test, P < 0.01), and was significantly lower among patients with MASA scores = 171 (log-rank test, P < 0.01). Cox regression analysis showed that FIM-motor (hazard ratio 0.97, P = 0.009) and MASA scores (hazard ratio 0.99, P < 0.01) were significantly associated with pneumonia. Conclusions In addition to the infectious risk, the FIM-motor and MASA scales are useful tools to predict the development of pneumonia in older adults. Geriatr Gerontol Int 2018; 18: 1620-1624.