Lee Byung Joo, Eo Hyoshin, Lee Changbae, Park Donghwi
Department of Rehabilitation Medicine, Daegu Fatima Hospital, Daegu 44033, Korea.
Department of Physical Medicine and Rehabilitation, College of Medicine, Ulsan University Hospital, University of Ulsan, Ulsan 44610, Korea.
Healthcare (Basel). 2021 May 27;9(6):632. doi: 10.3390/healthcare9060632.
The Videofluoroscopic Dysphagia Scale (VDS) is used to predict the long-term prognosis of dysphagia in patients with strokes. However, the inter-rater reliability of the VDS was low in a previous study. To overcome the mentioned limitations of the VDS, the modified version of the VDS (mVDS) was created and clinically applied to evaluate its usefulness in choosing the feeding method for stroke patients with dysphagia.
The videofluoroscopic swallowing study (VFSS) data of 56 stroke patients with dysphagia were collected retrospectively. We investigated the presence of aspiration pneumonia and the selected feeding method. We also evaluated the correlations between the mVDS and the selected feeding method, and between the mVDS and the presence of aspiration pneumonia after stroke. Univariate logistic regression and receiver operating characteristic analyses were used in the data analysis.
The inter-rater reliability (Cronbach α value) of the total score of the mVDS was 0.886, which was consistent with very good inter-rater reliability. In all patients with dysphagia, the supratentorial stroke subgroup, and the infratentorial stroke subgroup, the mVDS scores were statistically correlated with the feeding method selected ( < 0.05) and the presence of aspiration pneumonia ( < 0.05).
The mVDS can be a useful scale for quantifying the severity of dysphagia, and it can be a useful tool in the clinical setting and in studies for interpreting the VFSS findings in stroke patients with dysphagia. Further studies with a greater number of patients and various stroke etiologies are required for more generalized applications of the mVDS.
视频荧光吞咽造影吞咽障碍量表（VDS）用于预测中风患者吞咽障碍的长期预后。然而，先前一项研究中VDS的评分者间信度较低。为克服VDS的上述局限性，创建了VDS的修订版（mVDS）并将其应用于临床，以评估其在为吞咽障碍中风患者选择进食方法方面的实用性。
回顾性收集56例吞咽障碍中风患者的视频荧光吞咽造影检查（VFSS）数据。我们调查了吸入性肺炎的发生情况和所选的进食方法。我们还评估了mVDS与所选进食方法之间以及mVDS与中风后吸入性肺炎的发生情况之间的相关性。数据分析采用单因素逻辑回归和受试者工作特征分析。
mVDS总分的评分者间信度（Cronbach α值）为0.886，与非常好的评分者间信度一致。在所有吞咽障碍患者、幕上中风亚组和幕下中风亚组中，mVDS评分与所选进食方法（<0.05）和吸入性肺炎的发生情况（<0.05）在统计学上相关。
mVDS可作为量化吞咽障碍严重程度的有用量表，并且在临床环境以及解释吞咽障碍中风患者VFSS结果的研究中可作为有用工具。为了更广泛地应用mVDS，需要对更多患者和各种中风病因进行进一步研究。
