Department of Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan.
Nutritional Therapy Support Center, Aichi Medical University Hospital, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan.
Nutrients. 2019 Dec 26;12(1):70. doi: 10.3390/nu12010070.
The study aimed to investigate the impact of sarcopenia and sarcopenia-related conditions on the development of swallowing disorders during hospitalization. Older adult inpatients (n = 8768) without swallowing disorders in the premorbid period were studied. Sarcopenia-related conditions were evaluated in terms of nutritional status, physical status, and ambulatory conditions as well as hand-grip strength and muscle mass assessed by calf circumference. Development of swallowing disorders was defined based on food texture at discharge from the hospital. The patients' mean age was 76.1 ± 6.9 years. A total of 374 (4.3%) patients developed swallowing disorders during hospitalization. They were older, with poorer nutritional status, and had more decline of physical performance than those without swallowing disorders. Performance Status score (odds ratio (OR) = 1.28 (1.12-1.46) < 0.001), ambulatory dependency (OR = 1.72 (1.09-2.71), = 0.020), malnutrition score (OR = 0.92 (0.87-0.97), = 0.002), insufficient nutritional intake (OR = 2.33 (1.60-3.40), < 0.001), and length of stay (OR = 1.01 (1.00-1.01), = 0.001) were independent contributing factors for swallowing disorder development in the multivariate analysis. The presence of possible sarcopenia was also a contributor to swallowing disorder development. In conclusion, swallowing disorders could develop in patients with possible sarcopenia and sarcopenia-related conditions during hospitalization. Clinicians should be aware of this risk and provide appropriate interventions to prevent sarcopenic dysphagia.
本研究旨在探讨肌少症及其相关情况对住院期间吞咽障碍发展的影响。研究对象为无预期间吞咽障碍的老年住院患者(n=8768)。从营养状况、身体状况和活动能力以及通过小腿围评估的握力和肌肉质量等方面评估肌少症相关情况。根据出院时食物质地定义吞咽障碍的发展情况。患者的平均年龄为 76.1±6.9 岁。共有 374(4.3%)名患者在住院期间发生吞咽障碍。与无吞咽障碍的患者相比,他们年龄更大,营养状况更差,身体机能下降更明显。表现状态评分(OR=1.28(1.12-1.46)<0.001)、活动依赖(OR=1.72(1.09-2.71),=0.020)、营养不良评分(OR=0.92(0.87-0.97),=0.002)、营养摄入不足(OR=2.33(1.60-3.40),<0.001)和住院时间(OR=1.01(1.00-1.01),=0.001)是多变量分析中吞咽障碍发展的独立影响因素。可能存在的肌少症也是吞咽障碍发展的一个因素。总之,在住院期间,可能存在肌少症和肌少症相关情况的患者可能会发生吞咽障碍。临床医生应意识到这一风险,并提供适当的干预措施以预防肌少性吞咽困难。