一个难以吞的药丸:老年创伤患者的床边缺食症查
Heather R Kregel1, Jan-Michael Van Gent2, Harper Halfacre2
1Department of Surgery, McGovern Medical School at the University of Texas Health Science Center, Houston, Texas; Center for Surgical Trials and Evidence-based Practice, McGovern Medical School at the University of Texas Health Science Center, Houston, Texas; Center for Translational Injury Research, McGovern Medical School at the University of Texas Health Science Center, Houston, Texas.
引言:
我们假设,床旁筛查试验(BSTs)能够识别出无明显吞咽困难的老年创伤患者的吞咽障碍。
方法:
年龄≥65岁的创伤患者符合入组条件。已知存在吞咽困难危险因素的患者被排除。所有患者均由护士和言语语言病理学家进行床旁吞咽功能筛查(BST),随后接受吞咽困难的诊断性确认检查。主要结局指标为BST的诊断试验特征。
结果:
在入组的139例患者中,29例(21%)存在吞咽困难。中位年龄为78岁(四分位距:72-85)。护士进行的床旁吞咽评估(BST)敏感度为0.12,特异度为0.96,阳性预测值为0.43,阴性预测值为0.81,准确率为0.79。言语和语言治疗师进行的床旁吞咽评估(BST)敏感度为0.38,特异度为0.76,阳性预测值为0.30,阴性预测值为0.82,准确率为0.68。
结论:
在无明显吞咽困难的老年人创伤人群中,吞咽障碍的发生率为21%,而吞咽筛查测试(BSTs)具有足够的特异性用于筛查,但敏感性较差。
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