Masanori Kimura1,2, Atsushi Naganuma3,4, Yusuke Ogawa1, Motoaki Inagawa1,2, Shinta Nishioka5, Ryo Momosaki6, Hidetaka Wakabayashi7. 1. Nutrition Support Team, National Hospital Organization Takasaki General Medical Center, Takasaki, Gunma, Japan. 2. Department of Oral and Maxillofacial Surgery, National Hospital Organization Takasaki General Medical Center, Takasaki, Gunma, Japan. 3. Nutrition Support Team, National Hospital Organization Takasaki General Medical Center, Takasaki, Gunma, Japan. naganuma.atsushi.nj@mail.hosp.go.jp. 4. Department of Gastroenterology, National Hospital Organization Takasaki General Medical Center, 36 Takamatsu-cho, Takasaki, Gunma, 370-0829, Japan. naganuma.atsushi.nj@mail.hosp.go.jp. 5. Department of Clinical Nutrition and Food Services, Nagasaki Rehabilitation Hospital, Nagasaki, Japan. 6. Department of Rehabilitation Medicine, Mie University Graduate School of Medicine, Mie, Japan. 7. Department of Rehabilitation Medicine, Tokyo Women's Medical University Hospital, Tokyo, Japan.
Abstract
PURPOSE: The purpose of this study was to use the food intake level scale (FILS) to clarify whether calf circumference (CC) and stroke contribute to an improvement of inpatient dysphagia. METHODS: We used the Japanese sarcopenic dysphagia database (n = 467) to analyze FILS data recorded at admission and after follow-up in 322 cases. A multivariate analysis was performed to determine whether CC and stroke improved the FILS by two points or more. RESULTS: The patient characteristics were as follows: 177 (55%) men; median age, 81 years; median body mass index, 20.3 kg/m2; median CC, 28.2 cm; presence of sarcopenic dysphagia, 183 (56.8%); history of stroke, 103 (32%); median FILS on admission (interquartile range (IQR)), 6 (2-7); and median FILS at the end of the observation (IQR), 7 (7-8). Comparison of FILS at admission and discharge showed that 137 patients had an improvement in the scale of two points or more, whereas 185 patients had no improvement. Multivariate logistic regression analysis showed the factors that were associated independently with an improvement in dysphagia were: age < 80 years (odds ratio (OR) 2.20, 95% confidence interval (CI) 1.36-3.54, p = 0.001); CC ≥ 29.4 cm (OR 2.19, 95% CI 1.33-3.61, p = 0.002); sex (OR 1.67, 95% CI 1.03-2.71, p = 0.037); and stroke (OR 1.85, 95% CI 1.09-3.16, p = 0.023). CONCLUSIONS: Our results suggest that a CC ≥ 29.4 cm and history of stroke contributed to an improvement of inpatient dysphagia at discharge. The contribution of the easy-to-measure CC to predict an improvement in swallowing function may be very useful in daily clinical practice.
PURPOSE: The purpose of this study was to use the food intake level scale (FILS) to clarify whether calf circumference (CC) and stroke contribute to an improvement of inpatient dysphagia. METHODS: We used the Japanese sarcopenic dysphagia database (n = 467) to analyze FILS data recorded at admission and after follow-up in 322 cases. A multivariate analysis was performed to determine whether CC and stroke improved the FILS by two points or more. RESULTS: The patient characteristics were as follows: 177 (55%) men; median age, 81 years; median body mass index, 20.3 kg/m2; median CC, 28.2 cm; presence of sarcopenic dysphagia, 183 (56.8%); history of stroke, 103 (32%); median FILS on admission (interquartile range (IQR)), 6 (2-7); and median FILS at the end of the observation (IQR), 7 (7-8). Comparison of FILS at admission and discharge showed that 137 patients had an improvement in the scale of two points or more, whereas 185 patients had no improvement. Multivariate logistic regression analysis showed the factors that were associated independently with an improvement in dysphagia were: age < 80 years (odds ratio (OR) 2.20, 95% confidence interval (CI) 1.36-3.54, p = 0.001); CC ≥ 29.4 cm (OR 2.19, 95% CI 1.33-3.61, p = 0.002); sex (OR 1.67, 95% CI 1.03-2.71, p = 0.037); and stroke (OR 1.85, 95% CI 1.09-3.16, p = 0.023). CONCLUSIONS: Our results suggest that a CC ≥ 29.4 cm and history of stroke contributed to an improvement of inpatient dysphagia at discharge. The contribution of the easy-to-measure CC to predict an improvement in swallowing function may be very useful in daily clinical practice.