Suárez-Escudero Juan Camilo, González-Franco Sara, Franco-Sánchez Isabela, Gómez-Ríos Elizabeth, Martínez-Moreno Lillyana
Universidad Pontificia Bolivariana. Medellín, Colombia. Universidad CES. Medellín, Colombia. E-mail:
Universidad Pontificia Bolivariana. Medellín, Colombia. E-mail:
Rev Cuid. 2024 Sep 1;15(3):e3861. doi: 10.15649/cuidarte.3861. eCollection 2024 Sep-Dec.
Neurogenic oropharyngeal dysphagia is a form of functional dysphagia usually caused by neurological and neuromuscular diseases, which produces several secondary complications. To improve its detection and characterization, models are emerging that integrate clinical variables to complement the physical examination of swallowing.
Develop an explanatory model to differentiate patients with neurogenic oropharyngeal dysphagia.
Case control study based on a set ofdata derived from the clinical examination of swallowing with neurological emphasis carried out in a sample of patients with neurogenic oropharyngeal dysphagia of neurological and neuromuscular causes (cases), and in healthy people (controls).
158 clinical variables were compared between both groups, where those with the greatest classification capacity were identified, integrated into an explanatory binary logistic regression model made up of nine variables: two history, two symptoms, three physical examination signs and two signs after consistency/volume test with food. The dependent variable was the category of being healthy or patient and the covariates were the clinical variables. Parameters reached by the model: Akaike information criterion 102 and Nagelkerke R2 0.78.
The nine variables that entered the model, together, largely explain the presence of neurogenic oropharyngeal dysphagia, and are accessible by physical examination of swallowing.
The model obtained can improve and/or complement the evaluation process carried out in patients with dysphagia of functional causes, neurological and neuromuscular diseases, in screening and diagnostic characterization processes.
神经源性口咽吞咽困难是一种功能性吞咽困难，通常由神经和神经肌肉疾病引起，会产生多种继发性并发症。为了改进其检测和特征描述，正在出现一些整合临床变量以补充吞咽体格检查的模型。
开发一种解释模型，以区分神经源性口咽吞咽困难患者。
病例对照研究，基于一组来自对神经源性口咽吞咽困难患者（病例组）和健康人（对照组）进行的以神经学为重点的吞咽临床检查数据。
比较了两组之间的158个临床变量，确定了分类能力最强的变量，并将其整合到一个由九个变量组成的解释性二元逻辑回归模型中：两个病史变量、两个症状变量、三个体格检查体征变量以及两个食物稠度/量测试后的体征变量。因变量是健康或患病的类别，协变量是临床变量。该模型达到的参数：赤池信息准则为102，Nagelkerke R2为0.78。
进入模型的九个变量共同在很大程度上解释了神经源性口咽吞咽困难的存在，并且可通过吞咽体格检查获得。
所获得的模型可以在筛查和诊断特征描述过程中改进和/或补充对功能性原因、神经和神经肌肉疾病引起的吞咽困难患者进行的评估过程。
