Work

Validation of the Fiberoptic Endoscopy Evaluation of Swallowing in Aspiration Pneumonia: Utility of the Hyodo Dysphagia Score in Predicting the Development of Aspiration Pneumonia

Year: 2025

Type: article

Abstract: Objective To analyze the characteristics of flexible endoscopic evaluation of swallowing (FEES) findings in patients with aspiration pneumonia using the Hyodo dysphagia score and to evaluate the risk of aspiration pneumonia. Design Retrospective study. Setting Observation in a single primary care institution. Participants Inpatients aged ≥20 years who underwent FEES in our hospital between April 2012 and March 2022. A total of 178 patients were eligible to calculate the Hyodo dysphagia score and were enrolled in this study. The mean ± SD age of the subjects was 73.4±13.3 years, and 116 of 178 patients (65.2%) were men. Intervention Not applicable. Main Outcome Measures The development of aspiration pneumonia. Results Eighty-four of 178 patients (47.2%) developed aspiration pneumonia. Age, oral intake status, and serum albumin levels were not significantly different between the pneumonia and nonpneumonia groups. The total and each parameter of the Hyodo dysphagia score were significantly higher in the pneumonia group than in the nonpneumonia group. Logistic regression analysis showed that salivary retention (odds ratio [OR], 1.60; 95% confidence interval [CI], 1.09-1.33; P =.016) and poor cough reflex (OR, 1.88; 95% CI, 1.42-2.49; P <.001) in the Hyodo dysphagia score were risk factors for aspiration pneumonia. The area under the curve of the receiver operating characteristic curve for the onset of pneumonia based on the total Hyodo dysphagia score was 0.75 (95% CI, 0.67-0.82). A cutoff value of 5 for the total Hyodo dysphagia score gave a sensitivity of 0.75 (95% CI, 0.67-0.83) and a specificity of 0.60 (95% CI, 0.49-0.71), with the Youden index having a maximum value of 0.35. Conclusions A cutoff value of 5 points for the total Hyodo dysphagia score was optimal in predicting the development of aspiration pneumonia. Salivary retention and poor cough reflex were risk factors for the development of pneumonia.

Source: Archives of Rehabilitation Research and Clinical Translation

DOI: 10.1016/j.arrct.2025.100435

Authors: Yoko Ibe, Masayuki Tazawa, Hironori Arii, Yumiko Nakao, Risa Toyama, Naoki Wada

Institutions: Gunma University Hospital, Gunma University

Language: English

Topic: Dysphagia Assessment and Management

Subfield: Speech and Hearing

Field: Health Professions

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,500