Northern Arizona University, Health Professions, Rm 313, 208 E. Pine Knoll Drive, Flagstaff, AZ, 86011, USA.
Northern Arizona University, Health Professions, 208 E. Pine Knoll Drive, Flagstaff, AZ, 86011, USA.
Dysphagia. 2022 Feb;37(1):11-20. doi: 10.1007/s00455-021-10244-0. Epub 2021 Jan 24.
Agreement between self-reported dysphagic symptoms and actual swallowing physiology can vary widely across individuals. The Eating Assessment Tool-10 (EAT-10) is a self-report questionnaire commonly used to identify individuals with oropharyngeal dysphagia, but its interpretation for highly prevalent populations is poorly defined. Our primary objective was to determine if correlation strength between EAT-10 and Penetration-Aspiration Scale (PAS) scores differed by dysphagia etiology. Our secondary objective was to identify clinical factors that were associated with a mismatch between EAT-10 scores and videofluoroscopic findings. Outpatients with Parkinson disease (PD), stroke, and/or head and neck cancer (HNC) who completed EAT-10 and underwent videofluoroscopy were included (n = 203). EAT-10/PAS correlations were calculated by dysphagia etiology. We found that across the sample, higher EAT-10 scores were significantly correlated to higher PAS scores (r = 0.31, p < 0.001). EAT-10 and PAS were moderately correlated in the HNC group (r = 0.41, p < 0.001, n = 87), but correlations were modest in the PD (r = 0.18, n = 41) and stroke groups (r = 0.12, n = 59). Clinical characteristics of individuals with a "matched" profile (normal EAT-10 score and normal swallow physiology) and a "mismatched" profile (normal EAT-10 score and abnormal swallow physiology) were also compared. Individuals with a "mismatched" EAT-10/PAS profile appeared to be significantly older and had a worse Charlson Comorbidity Index than individuals with a "matched" profile. Within the HNC subgroup, EAT-10/PAS correlations for specific tumor sites, treatment types, and time since treatment are reported. Clinicians may consider these aspiration risk profiles when making recommendations for instrumented swallowing assessment.
自我报告的吞咽困难症状与实际吞咽生理学之间的一致性在个体之间差异很大。进食评估工具-10（EAT-10）是一种常用的自我报告问卷，用于识别口咽性吞咽困难患者，但对于高患病率人群的解释尚不清楚。我们的主要目的是确定 EAT-10 与渗透-吸入量表（PAS）评分之间的相关性强度是否因吞咽困难病因而异。我们的次要目标是确定与 EAT-10 评分与视频透视结果不匹配相关的临床因素。完成 EAT-10 并接受视频透视的帕金森病（PD）、中风和/或头颈部癌症（HNC）门诊患者被纳入研究（n = 203）。根据吞咽困难病因计算 EAT-10/PAS 相关性。我们发现，在整个样本中，EAT-10 评分越高，与 PAS 评分越高呈显著正相关（r = 0.31，p < 0.001）。在 HNC 组中，EAT-10 和 PAS 呈中度相关（r = 0.41，p < 0.001，n = 87），但在 PD 组（r = 0.18，n = 41）和中风组中相关性较低（r = 0.12，n = 59）。比较了具有“匹配”特征（正常 EAT-10 评分和正常吞咽生理学）和“不匹配”特征（正常 EAT-10 评分和异常吞咽生理学）个体的临床特征。具有“不匹配”EAT-10/PAS 特征的个体似乎比具有“匹配”特征的个体年龄更大，Charlson 合并症指数更差。在 HNC 亚组中，报告了特定肿瘤部位、治疗类型和治疗后时间的 EAT-10/PAS 相关性。临床医生在推荐仪器吞咽评估时可以考虑这些吸入风险特征。
