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体质指数对吞咽困难患者肌少性吞咽困难诊断的敏感性和特异性:一项多中心横断面研究。

Sensitivity and Specificity of Body Mass Index for Sarcopenic Dysphagia Diagnosis among Patients with Dysphagia: A Multi-Center Cross-Sectional Study.

机构信息

Department of Nursing Care, Sendai Kosei Hospital, Sendai 980-0873, Japan.

Department of Rehabilitation Medicine, Tokyo Women's Medical University Hospital, Tokyo 162-8666, Japan.

出版信息

Nutrients. 2022 Oct 26;14(21):4494. doi: 10.3390/nu14214494.

Abstract

The accuracy of body mass index (BMI) for sarcopenic dysphagia diagnosis, which remains unknown, was evaluated in this study among patients with dysphagia. We conducted a 19-site cross-sectional study. We registered 467 dysphagic patients aged ≥ 20 years. Sarcopenic dysphagia was assessed using a reliable and validated diagnostic algorithm. BMI was assessed using the area under the curve (AUC) in the receiver operating characteristic analysis to determine diagnostic accuracy for sarcopenic dysphagia. The study included 460 patients (median age, 83.0 years (76.0−88.0); men, 49.8%). The median BMI was 19.9 (17.3−22.6) kg/m2. Two hundred eighty-four (61.7%) patients had sarcopenic dysphagia. The AUC for sarcopenic dysphagia was 0.60−0.62 in the overall patients, male, female, and patients aged ≥ 65 years The BMI cut-off value for sarcopenic dysphagia diagnosis was 20.1 kg/m2 in the overall patients (sensitivity, 58.1%; specificity, 60.2%) and patients aged ≥ 65 years (sensitivity, 59.8%; specificity, 61.8%). Conclusion: Although the AUC, sensitivity and specificity of BMI for sarcopenic dysphagia diagnosis was approximately 0.6, BMI < 20.0 kg/m2 might be a predictor for sarcopenic dysphagia. In clinical settings, if patients with dysphagia have a BMI < 20.0 kg/m2, then sarcopenic dysphagia should be suspected as early as possible after admission.

摘要

体质指数(BMI)用于诊断肌少性吞咽困难的准确性尚不清楚,本研究旨在评估其在吞咽困难患者中的应用。我们进行了一项 19 个地点的横断面研究。我们登记了 467 名年龄≥20 岁的吞咽困难患者。使用可靠和验证的诊断算法评估肌少性吞咽困难。使用受试者工作特征分析中的曲线下面积(AUC)评估 BMI 对肌少性吞咽困难的诊断准确性。该研究纳入了 460 名患者(中位年龄 83.0 岁(76.0-88.0);男性占 49.8%)。中位 BMI 为 19.9(17.3-22.6)kg/m2。284 名(61.7%)患者存在肌少性吞咽困难。在所有患者、男性、女性和年龄≥65 岁的患者中,肌少性吞咽困难的 AUC 为 0.60-0.62。对于所有患者(敏感性 58.1%,特异性 60.2%)和年龄≥65 岁的患者(敏感性 59.8%,特异性 61.8%),BMI 用于诊断肌少性吞咽困难的截断值为 20.1kg/m2。结论:尽管 BMI 用于诊断肌少性吞咽困难的 AUC、敏感性和特异性约为 0.6,但 BMI<20.0kg/m2 可能是肌少性吞咽困难的预测指标。在临床环境中,如果吞咽困难患者的 BMI<20.0kg/m2,则应在入院后尽早怀疑肌少性吞咽困难。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2d21/9655070/13f549eb0fc3/nutrients-14-04494-g001.jpg

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