Usefulness of the Modified Videofluoroscopic Dysphagia Scale in Determining the Allowance of Oral Feeding in Patients with Dysphagia Due to Deconditioning or Frailty.

Introduction: In patients with dysphagia due to deconditioning or frailty, as with other disorders that cause swallowing disorders, the videofluoroscopic swallowing study (VFSS) is the gold standard for dysphagia evaluation. However, the interpretation of VFSS results is somewhat complicated and requires considerable experience in the field. Therefore, in this study we evaluated the usefulness of the modified videofluoroscopic dysphagia scale (mVDS) in determining whether to allow oral feeding in patients with dysphagia due to deconditioning or frailty. Methods: Data from the VFSS of 50 patients with dysphagia due to deconditioning or frailty were retrospectively collected. We evaluated the association between mVDS and the selected feeding method based on VFSS findings, and between mVDS and the presence of aspiration pneumonia. Results: Multivariate logistic analysis showed that the mVDS total score had a significant association with oral feeding methods based on VFSS findings in patients with dysphagia due to deconditioning or frailty (p < 0.05). In the receiver operating characteristic (ROC) curve analysis, the area under the ROC curve for the selected feeding method was 0.862 (95% confidence interval, 0.747−0.978; p < 0.0001). Conclusions: mVDS seems a valid scale for determining the allowance of oral feeding, and it can be a useful tool in the clinical setting and in studies that aim to interpret VFSS findings in patients with dysphagia due to deconditioning or frailty. However, studies involving a more general population of patients with dysphagia due to deconditioning or frailty are needed.