实用老年医学

实用老年医学 ›› 2025, Vol. 39 ›› Issue (5): 524-529.doi: 10.3969/j.issn.1003-9198.2025.05.018

• 临床研究 • 上一篇    下一篇

老年人吞咽障碍风险因素分析和风险评估模型构建

闫翔, 李小良, 宋辉, 郭璐, 陈世朝, 范娟宁, 杨静, 徐梅, 赵思竹, 杨孝光, 程弦宗, 李运明   

  1. 610083 四川省成都市,中国人民解放军西部战区总医院干部病房(闫翔,李小良,宋辉,郭璐,陈世朝,范娟宁,杨静,徐梅,赵思竹);医疗保障中心信息科(杨孝光,李运明); 610500 四川省成都市,成都医学院公共卫生学院(程弦宗)
  • 收稿日期:2024-07-19 出版日期:2025-05-20 发布日期:2025-05-20
  • 通讯作者: 李运明,Email:lee3082@sina.com
  • 基金资助:
    全军保健专项科研课题(21BJZ39,2021-XZYG-C06);西部战区总医院“头雁”工程项目

Analysis of risk factors and construction of risk assessment model for dysphagia in the elderly

YAN Xiang, LI Xiaoliang, SONG Hui, GUO Lu, CHEN Shizhao, FAN Juanning, YANG Jing, XU Mei, ZHAO Sizhu, YANG Xiaoguang, CHENG Xianzong, LI Yunming   

  1. Department of Geratology (YAN Xiang, LI Xiaoliang, SONG Hui, GUO Lu, CHEN Shizhao, FAN Juanning, YANG Jing, XU Mei, ZHAO Sizhu); Department of Medical Support Center Information (YANG Xiaoguang, LI Yunming), the General Hospital of Western Theater Command, PLA, Chengdu 610083, China; School of Public Health, Chengdu Medical College, Chengdu 610500, China (CHENG Xianzong)
  • Received:2024-07-19 Online:2025-05-20 Published:2025-05-20
  • Contact: LI Yunming, Email: lee3082@sina.com

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摘要： 目的 探讨老年人发生吞咽障碍的风险因素,构建吞咽障碍风险评估模型。 方法 选取在成都地区18所军队干休所居住的251例离退休老年人作为研究对象,采用进食评估问卷调查表(Eating Assessment Tool,EAT-10)评估老年人吞咽障碍发生情况,并开展肌少症、Barthel指数、营养风险筛查等老年综合评估,采用logistic回归分析老年人发生吞咽障碍的风险因素,构建吞咽障碍风险评估模型。 结果 入组人群吞咽障碍患病率为42.23%(95%CI:36.12%~48.34%)。多因素logistic回归分析发现,长期使用镇静催眠药、有饮水呛咳史、低Barthel指数是老年人发生吞咽障碍的风险因素(P<0.05)。选取以上风险因素绘制吞咽障碍风险评估模型列线图,模型的AUC为0.796(95%CI:0.738~0.855);通过Bootstrap自抽样法内部验证,模型C-index指数为0.593,平均绝对误差为0.017,提示模型具有较好的区分度和校准度。 结论 长期使用镇静催眠药、有饮水呛咳史、Barthel指数评分低会导致老年人吞咽障碍的发生风险增加,利用上述3个风险因素构建的老年人群吞咽障碍风险评估模型具有良好的预测能力。

关键词: 老年人, 吞咽障碍, 影响因素, 风险评估模型, 列线图

Abstract: Objective To investigate the risk factors for dysphagia in the elderly and to construct a dysphagia risk assessment model. Methods A total of 251 elderly people in 18 military cadre retirement centers in Chengdu were enrolled in this study. The Eating Assessment Tool (EAT-10) was used to evaluate the occurrence of swallowing disorders in the elderly, and comprehensive geriatric assessment including sarcopenia, Barthel index and nutritional risk screening were conducted. Logistic regression analysis was used to analyze the risk factors for dysphagia in the elderly, and a dysphagia risk assessment model was constructed. Results The prevalence rate of dysphagia in the enrolled elderly was 42.23% (95%CI:36.12%-48.34%). Multivariable logistic regression analysis showed that long term use of sedatives and hypnotics, history of coughing upon drinking water, and low Barthel index were the risk factors for dysphagia in the elderly. The area under the curve of the nomogram model constructed by the above risk factors was 0.796 (95%CI: 0.738-0.855). Bootstrap method was used for internal validation, with a C-index of 0.593 and an average absolute error of 0.020, indicating that the model had good discrimination and calibration. Conclusions Long term use of sedatives and hypnotics, history of coughing upon drinking water, and low Barthel index can increase the risk of swallowing disorders in the elderly. The dysphagia risk assessment model developed using the three risk factors has good predictive ability in the elderly.

Key words: aged, dysphagia, influencing factor, risk assessment model, nomogram

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