Determination of the cut-off score of an endoscopic scoring method to predict whether elderly patients with dysphagia can eat pureed diets

摘要

AIM: To identify the cut-off value for predicting the ability of elderly patients with dysphagia to swallow pureed diets using a new endoscopy scoring method. METHODS: Endoscopic swallowing evaluation of pureed diets were done in patients ≥ 65 years with dysphagia. The Hyodo-Komagane score for endoscopic swallowing evaluation is expressed as the sum(0-12) of four degrees(0-3) with four parameters:(1) salivary pooling in the vallecula and piriform sinuses;(2) the response of glottal closure reflex induced by touching the epiglottis with the endoscope;(3) the location of the bolus at the time of swallow onset assessed by "white-out" following swallowing of test jelly; and(4) pharyngeal clearance after swallowing of test jelly. We used receiver operating characteristic(ROC) curve analysis to retrospectively analyze the association between the total score and successful oral intake of pureed diets. RESULTS: One hundred and seventy-eight patients were enrolled including 113 men(63%), mean age 83 years(range, 66-98). One hundred and twenty-six patients(71%) were able to eat pureed diets during the observation period(mean ± SD, 19 ± 14 d). In ROC analysis, the cut-off value of the score for eating the pureed diets was 7(sensitivity = 0.98; specificity = 0.91).CONCLUSION: The Hyodo-Komagane endoscopic score is useful to predict the ability to eat pureed diets in elderly patients with dysphagia.