The Prevalence and Prognosis of Sarcopenic Dysphagia in Patients Who Require Dysphagia Rehabilitation

摘要

ObjectivesThe purpose of this study was to assess the prevalence and prognosis of sarcopenic dysphagia in patients who require dysphagia rehabilitation.DesignProspective cohort study.SettingTertiary-care acute general hospital.ParticipantsOne hundred and eight patients referred to the Department of Rehabilitation Medicine for dysphagia rehabilitation.MeasurementsThe Food Intake Level Scale (FILS), a 5-step diagnostic algorithm for sarcopenic dysphagia.ResultsThe study included 72 males and 36 females (mean age, 767 years). Comorbid diseases included brain and nervous system disease (36%), cardiovascular disease (25%), respiratory disease (14%), and cancer (11%). Median energy intake was 1159 kcal (interquartile range: 648, 1502). Median FILS at admission and discharge was 4 (interquartile range: 2, 7) and 8 (interquartile range: 5, 8), respectively. Sarcopenic dysphagia was observed in 35 patients (32%). Sarcopenic dysphagia was associated with lower FILS at referral and discharge, lower calf circumference, lower handgrip strength, lower body mass index, lower serum albumin, and higher C-reactive protein at referral. Tongue pressure, energy intake, and Barthel index did not differ significantly between patients with or without sarcopenic dysphagia. Ordered logistic regression analysis of the FILS at discharge adjusted for presence of sarcopenic dysphagia, age, sex, and the FILS at admission revealed that presence of sarcopenic dysphagia (=-1.603, 95% confidence intervals= -2.609, -0.597, p=0.002), sex, and the FILS at admission were independently associated with the FILS at discharge.ConclusionsThe prevalence of sarcopenic dysphagia in patients who require dysphagia rehabilitation was quite high. Sarcopenic dysphagia was independently associated with poor swallowing function at discharge.