{"title":"Pulmonary function and sarcopenia as predictors of dysphagia in cervical spinal cord injury","authors":"Su Ji Lee, Ji Cheol Shin","doi":"10.1038/s41393-023-00946-7","DOIUrl":null,"url":null,"abstract":"Retrospective cohort study. To determine the risk factors associated with dysphagia in individuals with cervical spinal cord injury (CSCI) and analyze the differences between individuals with improved penetration–aspiration (PA) and persistent PA on follow-up. Tertiary inpatient rehabilitation facilities. Medical records of individuals with CSCI admitted between December 2009 and February 2023 who underwent a videofluoroscopic swallowing study (VFSS) were retrospectively reviewed. Multivariate logistic regression analysis was performed to assess risk factors for dysphagia. Differences between individuals with improved PA and persistent PA were analyzed using an independent t-test. In total, 149 participants were enrolled. Age (odds ratio (OR) 1.08, 95% confidence interval (CI) 1.04–1.12), percentage of forced vital capacity to predicted normal (FVC (% predicted)) (OR 0.90, 95% CI 0.85–0.94), and skeletal muscle index (OR 0.89, 95% CI, 0.79–0.99) were significant factors associated with the risk of PA. Based on the receiver operating characteristic curve analysis, the cut-off values for age, FVC (% predicted), and skeletal muscle index were determined as 56.0, 45.7, and 41.0, respectively. A secondary analysis of the follow-up VFSS was conducted on 38 participants. The follow-up FVC (% predicted) and degree of weight loss differed significantly between the improved PA and persistent PA groups. Older age, low FVC (% predicted), and low skeletal muscle index can be predictors of dysphagia in patients with CSCI. On follow-up VFSS, individuals with improved PA demonstrated greater improvement in FVC (% predicted).","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":null,"pages":null},"PeriodicalIF":2.1000,"publicationDate":"2023-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Spinal cord","FirstCategoryId":"3","ListUrlMain":"https://www.nature.com/articles/s41393-023-00946-7","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Retrospective cohort study. To determine the risk factors associated with dysphagia in individuals with cervical spinal cord injury (CSCI) and analyze the differences between individuals with improved penetration–aspiration (PA) and persistent PA on follow-up. Tertiary inpatient rehabilitation facilities. Medical records of individuals with CSCI admitted between December 2009 and February 2023 who underwent a videofluoroscopic swallowing study (VFSS) were retrospectively reviewed. Multivariate logistic regression analysis was performed to assess risk factors for dysphagia. Differences between individuals with improved PA and persistent PA were analyzed using an independent t-test. In total, 149 participants were enrolled. Age (odds ratio (OR) 1.08, 95% confidence interval (CI) 1.04–1.12), percentage of forced vital capacity to predicted normal (FVC (% predicted)) (OR 0.90, 95% CI 0.85–0.94), and skeletal muscle index (OR 0.89, 95% CI, 0.79–0.99) were significant factors associated with the risk of PA. Based on the receiver operating characteristic curve analysis, the cut-off values for age, FVC (% predicted), and skeletal muscle index were determined as 56.0, 45.7, and 41.0, respectively. A secondary analysis of the follow-up VFSS was conducted on 38 participants. The follow-up FVC (% predicted) and degree of weight loss differed significantly between the improved PA and persistent PA groups. Older age, low FVC (% predicted), and low skeletal muscle index can be predictors of dysphagia in patients with CSCI. On follow-up VFSS, individuals with improved PA demonstrated greater improvement in FVC (% predicted).
期刊介绍:
Spinal Cord is a specialised, international journal that has been publishing spinal cord related manuscripts since 1963. It appears monthly, online and in print, and accepts contributions on spinal cord anatomy, physiology, management of injury and disease, and the quality of life and life circumstances of people with a spinal cord injury. Spinal Cord is multi-disciplinary and publishes contributions across the entire spectrum of research ranging from basic science to applied clinical research. It focuses on high quality original research, systematic reviews and narrative reviews.
Spinal Cord''s sister journal Spinal Cord Series and Cases: Clinical Management in Spinal Cord Disorders publishes high quality case reports, small case series, pilot and retrospective studies perspectives, Pulse survey articles, Point-couterpoint articles, correspondences and book reviews. It specialises in material that addresses all aspects of life for persons with spinal cord injuries or disorders. For more information, please see the aims and scope of Spinal Cord Series and Cases.