The prediction of persistent dysphagia beyond six months after stroke
The prediction of persistent dysphagia beyond six months after stroke
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DOI：
10.1007/s00455-007-9097-0
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发表时间：
2008-03-01
期刊：
影响因子：
2.6
通讯作者：
Kwon, Bum Sun
中科院分区：
文献类型：
--
作者：
Han, Tai Ryoon;Paik, Nam-Jong;Kwon, Bum Sun
本研究的目的是确定影响中风后早期吞咽功能恢复的电视荧光镜预后因素，并建立预测长期预后的工具。前瞻性地选择了 83 名中风后患者。这些患者均在中风发作后平均 40 天接受了电视透视吞咽检查，并随访了六个月以上。预后因素通过六个月内基线电视透视检查结果和抽吸之间的逻辑回归分析确定（p < 0.05）。根据预后因素的比值比制定电视荧光吞咽困难量表（VDS），总分为100。通过使用受试者工作特征曲线来评估量表的有效性。 VDS使用以下14个项目编制：唇部闭合、食团形成、咀嚼、失用、舌腭接触、食团过早丢失、口腔通过时间、咽部吞咽触发、谷残留、喉抬高、梨状窦残留、咽壁涂层、咽通过时间和抽吸。当量表截止值为 47 时，敏感性为 0.91，特异性为 0.92。 VDS 的开发目的是用作中风后长期持续性吞咽困难的客观且可量化的预测指标。
The purpose of this study was to identify the videofluoroscopic prognostic factors that affect the recovery of swallowing function at an early stage after stroke and to make a tool for predicting the long-term prognosis. Eighty-three poststroke patients were selected prospectively. These patients had all undergone videofluoroscopic swallowing studies at an average of 40 days after stroke onset and were followed up for over six months. Prognostic factors were determined by logistic regression analysis between the baseline videofluoroscopic findings and aspiration over six months (p < 0.05). A videofluoroscopic dysphagia scale (VDS) with a sum of 100 was made according to the odds ratios of prognostic factors. The validity of the scale was evaluated by using a receiver operating characteristic curve. The VDS was compiled using the following 14 items: lip closure, bolus formation, mastication, apraxia, tongue-to-palate contact, premature bolus loss, oral transit time, triggering of pharyngeal swallow, vallecular residue, laryngeal elevation, pyriform sinus residue, coating of pharyngeal wall, pharyngeal transit time, and aspiration. At a scale cutoff value of 47, the sensitivity was 0.91 and the specificity was 0.92. The VDS was developed to be used as an objective and quantifiable predictor of long-term persistent dysphagia after stroke.