Wakabayashi Hidetaka, Takahashi Rimiko, Watanabe Naoko, Oritsu Hideyuki, Shimizu Yoshitaka
Department of Rehabilitation Medicine, Yokohama City University Medical Center, Yokohama, Japan.
Department of Rehabilitation Medicine, Yokohama City University Medical Center, Yokohama, Japan.
Nutrition. 2017 Jun;38:70-73. doi: 10.1016/j.nut.2017.01.010. Epub 2017 Feb 2.
The aim of this study was to assess the prevalence of skeletal muscle mass loss and its association with swallowing function in patients with dysphagia after cardiovascular surgery.
A retrospective cohort study was performed in 65 consecutive patients with dysphagia after cardiovascular surgery who were prescribed speech therapy. Skeletal muscle index (SMI) was calculated as total psoas muscle area assessed via abdominal computed tomography divided by height squared. Cutoff values were 6.36 cm/m for men and 3.92 cm/m for women. The Food Intake Level Scale (FILS) was used to assess the swallowing function. Univariate and ordered logistic regression analyses were applied to examine the associations between skeletal muscle mass loss and dysphagia.
The study included 50 men and 15 women (mean age 73 ± 8 y). The mean SMI was 4.72 ± 1.37 cm/m in men and 3.33 ± 1.42 cm/m in women. Skeletal muscle mass loss was found in 53 (82%) patients. Twelve had tracheostomy cannula. Thirteen were non-oral feeding (FILS levels 1-3), 5 were oral food intake and alternative nutrition (levels 4-6), and 47 were oral food intake alone (levels 7-9) at discharge. The FILS at discharge was significantly lower in patients with skeletal muscle mass loss. Ordered logistic regression analysis of swallowing function showed that skeletal muscle mass loss and tracheostomy cannula were associated independently with the FILS at discharge.
The prevalence of skeletal muscle mass loss is very high, and skeletal muscle mass loss is associated with swallowing function.
本研究旨在评估心血管手术后吞咽困难患者骨骼肌质量损失的患病率及其与吞咽功能的关系。
对65例连续接受心血管手术后吞咽困难并接受言语治疗的患者进行回顾性队列研究。骨骼肌指数（SMI）计算为通过腹部计算机断层扫描评估的腰大肌总面积除以身高的平方。男性的临界值为6.36 cm/m，女性为3.92 cm/m。采用食物摄入水平量表（FILS）评估吞咽功能。应用单因素和有序逻辑回归分析来检验骨骼肌质量损失与吞咽困难之间的关系。
该研究纳入了50名男性和15名女性（平均年龄73±8岁）。男性的平均SMI为4.72±1.37 cm/m，女性为3.33±1.42 cm/m。53例（82%）患者存在骨骼肌质量损失。12例有气管切开套管。出院时，13例为非经口喂养（FILS水平1 - 3），5例为经口食物摄入并辅以替代营养（水平4 - 6），47例仅经口食物摄入（水平7 - 9）。骨骼肌质量损失患者出院时的FILS显著较低。吞咽功能的有序逻辑回归分析表明，骨骼肌质量损失和气管切开套管与出院时的FILS独立相关。
骨骼肌质量损失的患病率非常高，且骨骼肌质量损失与吞咽功能相关。
