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入院 24 小时内早期评估吞咽功能对出院时口服摄食量的预测:一项回顾性队列研究。

Prediction of Oral Intake at Discharge with Early Assessment of Swallowing Function within 24 h after Admission: A Retrospective Cohort Study.

机构信息

Department of Rehabilitation, Brain Attack Center Ota Memorial Hospital, Hiroshima, Japan.

Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, 1-98 Dengakugakubo, Kutsukake, Toyoake, Aichi, 470-1192, Japan.

出版信息

Dysphagia. 2024 Dec;39(6):1163-1170. doi: 10.1007/s00455-024-10699-x. Epub 2024 Apr 1.

Abstract

Dysphagia is one of the most common symptoms of stroke and can lead to other complications such as pneumonia, dehydration, and malnutrition. This retrospective cohort study evaluated the predictive value of a comprehensive swallowing assessment tool, the Mann Assessment of Swallowing Ability (MASA), in the acute phase of stroke for oral intake status at discharge. Among 1,133 consecutive patients with acute stroke, 512 patients whose swallowing function was assessed using the MASA within 24 h of admission were included. Data including demographic information, stroke severity, MASA, Oral Health Assessment Tool, body mass index, and serum albumin level were collected. Predictive factors for oral intake were analyzed using a multiple logistic regression model, and the receiver operating characteristic (ROC) curve analysis was used to determine the cutoff values of the MASA score for determining oral intake at discharge. Oral intake at discharge was established in 69.1% of the cohort (354/512). The multiple logistic regression analysis identified a higher MASA score, younger age, and higher serum albumin level as significant predictors of oral intake at discharge. The cutoff value of the MASA score for oral intake was 136.5 points, with an area under the ROC curve of 0.87. These findings suggest that the MASA is a valid tool for predicting oral intake in patients with dysphagia during the acute phase of stroke.

摘要

吞咽困难是中风最常见的症状之一,可导致其他并发症,如肺炎、脱水和营养不良。本回顾性队列研究评估了一种全面的吞咽评估工具——吞咽能力评估量表(MASA)在中风急性期对出院时口服摄入状态的预测价值。在 1133 例连续急性中风患者中,纳入了 512 例在入院 24 小时内使用 MASA 评估吞咽功能的患者。收集的数据包括人口统计学信息、中风严重程度、MASA、口腔健康评估工具、体重指数和血清白蛋白水平。使用多因素逻辑回归模型分析了口服摄入的预测因素,并使用受试者工作特征(ROC)曲线分析确定了 MASA 评分用于确定出院时口服摄入的截断值。该队列中 69.1%(354/512)的患者出院时可以口服摄入。多因素逻辑回归分析确定了较高的 MASA 评分、较年轻的年龄和较高的血清白蛋白水平是出院时口服摄入的显著预测因素。MASA 评分用于预测口服摄入的截断值为 136.5 分,ROC 曲线下面积为 0.87。这些发现表明,MASA 是预测中风急性期吞咽困难患者口服摄入的有效工具。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/20e8/11607090/1d9526f2ac51/455_2024_10699_Fig1_HTML.jpg

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