Volume 23 Issue 4
Apr.  2025
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Article Navigation >  Chinese Journal of General Practice  > 2025  >  23(4): 551-554
HU Lingqin, WANG Xiaohua, REN Yili, WANG Jun. Construction of a nomogram for predicting malnutrition risk in elderly patients with pharyngeal dysphagia after stroke[J]. Chinese Journal of General Practice, 2025, 23(4): 551-554. doi: 10.16766/j.cnki.issn.1674-4152.003947
Citation: HU Lingqin, WANG Xiaohua, REN Yili, WANG Jun. Construction of a nomogram for predicting malnutrition risk in elderly patients with pharyngeal dysphagia after stroke[J]. Chinese Journal of General Practice, 2025, 23(4): 551-554. doi: 10.16766/j.cnki.issn.1674-4152.003947
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Construction of a nomogram for predicting malnutrition risk in elderly patients with pharyngeal dysphagia after stroke

doi: 10.16766/j.cnki.issn.1674-4152.003947

  • Department of Geriatrics, Affiliated Hospital of Shaoxing University, Shaoxing, Zhejiang 312000, China

Funds:

 2021ZB310

  • Received Date: 2024-07-24
    Available Online: 2025-06-30
    Abstract
  •   Objective  To construct a nomogram tool for screening malnutrition risk in elderly patients with pharyngeal swallowing disorders after stroke, aiming to improve the accuracy of malnutrition assessment.  Methods  A total of 115 elderly patients with post-stroke pharyngeal dysphagia disorder admitted to Affiliated Hospital of Shaoxing University from December 2020 to December 2023 were selected and divided into a malnutrition group (MNA score < 17 points, n=43) and a non-malnutrition group (MNA score ≥17 points, n=72) according to the micro-nutrition assessment (MNA) score. Multivariate logistic regression analysis was used to screen the risk factors for malnutrition, and R software component nomogram model was used to verify the model.  Results  Among the 115 elderly patients with pharyngeal dysphagia after stroke, 43 (37.39%) were diagnosed with malnutrition. Multivariate logistic regression showed delayed swallowing initiation, aspiration, aCCI score, feeding method, and epiglottic reversion disorder as independent risk factors for malnutrition in elderly patients after stroke (OR>1, P < 0.05). Based on the above five indexes, the malnutrition risk prediction model of dysphagia in elderly stroke was constructed, achieving an area under the ROC curve of 0.959 (95% CI: 0.904-0.987). The calibration curve demonstrated good agreement, with a Hosmer-Lemeshow test result of χ2=8.254, P=0.628.  Conclusion  Elderly patients with laryngeal swallowing dysfunction after stroke have a high incidence of malnutrition. Key risk factors include delayed swallowing initiation, aspiration, aCCI score, feeding method, and epiglottic reentry disorder. The nomogram model established in this study can provide a reliable tool for early warning and identification of malnutrition in elderly patients with laryngeal swallowing dysfunction after stroke.

     

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    • References(20)
  • [1]
    中国康复医学会吞咽障碍康复专业委员会. 中国吞咽障碍康复管理指南(2023版)[J]. 中华物理医学与康复杂志, 2023, 45(12): 1057-1072. doi: 10.3760/cma.j.issn.0254-1424.2023.12.001

    Chinese Society of Rehabilitation Medicine Rehabilitation Committee for Swallowing Disorders. Guidelines for the management of dysphagia rehabilitation in China (2023 edition)[J]. Chinese Journal of Physical Medicine and Rehabilitation, 2023, 45(12): 1057-1072. doi: 10.3760/cma.j.issn.0254-1424.2023.12.001
    [2]
    张莉, 孙洁, 唐艳, 等. FEES联合DSS对卒中后咽反射消失吞咽障碍的诊断价值[J]. 中国实用神经疾病杂志, 2024, 27(2): 170-175.

    ZHANG L, SUN J, TANG Y, et al. Diagnostic value of FEES combined with DSS for swallowing disorders in patients with post-stroke loss of pharyngeal reflex[J]. Chinese Journal of Practical Nervous Diseases, 2024, 27(2): 170-175.
    [3]
    李巧丽. 脑卒中吞咽障碍患者集束化摄食训练方案的构建与应用[D]. 郑州: 河南大学, 2023.

    LI Q L. Construction and application of a focused ingestion training programme for stroke patients with swallowing disorders[D]. Zhengzhou: Henan University, 2023.
    [4]
    李振亚, 孙洁, 郭鹏飞, 等. 脑卒中患者口期和咽期吞咽功能改变与误吸的相关性: 基于电视透视吞咽检查[J]. 中国康复理论与实践, 2023, 29(8): 933-939. doi: 10.3969/j.issn.1006-9771.2023.08.010

    LI Z Y, SUN J, GUO P F, et al. Correlation between changes of swallowing function in oral and pharyngeal phases, and aspiration in stroke pa-tients based on videofluroscopic swallowing study[J]. Chinese Journal of Rehabilitation Theory and Practice, 2023, 29(8): 933-939. doi: 10.3969/j.issn.1006-9771.2023.08.010
    [5]
    涂润泽, 曾翼翔, 赵书聪, 等. 针刀分期调治卒中后咽期吞咽障碍临证探讨[J]. 山西中医药大学学报, 2023, 24(10): 1111-1115.

    TU R Z, ZENG Y X, ZHAO S C, et al. Clinical study of acupotomy staging in the treatment of dysphagia in the posterior pharyngeal stage after stroke[J]. Journal of Shanxi University of Chinese Medicine, 2023, 24(10): 1111-1115.
    [6]
    卓玉荣, 武珏瑛. 营养风险筛查指导下进行营养支持治疗对出血性脑卒中伴吞咽障碍患者营养状况及康复进程的影响[J]. 中国基层医药, 2021, 28(12): 1852-1855. doi: 10.3760/cma.j.issn.1008-6706.2021.12.020

    ZHUO Y R, WU J Y. Effects of the nutritional risk screening 2002-based nutritional therapy on nutritional status and rehabilitation process in hemorrhagic stroke patients with dysphagia[J]. Chinese Journal of Primary Medicine and Pharmacy, 2021, 28(12): 1852-1855. doi: 10.3760/cma.j.issn.1008-6706.2021.12.020
    [7]
    中华神经科学会, 中华神经外科学会. 各类脑血管疾病诊断要点[J]. 中国实用内科杂志, 1997(5): 56.

    Chinese Society of Neurology, Chinese Society of Neurosurgery. Diagnosis of various cerebrovascular diseases[J]. Chinese Journal of Practical Internal Medicine, 1997(5): 56.
    [8]
    中国吞咽障碍康复评估与治疗专家共识组. 中国吞咽障碍评估与治疗专家共识(2017年版)第一部分评估篇[J]. 中华物理医学与康复杂志, 2017, 39(12): 881-892. doi: 10.3760/cma.j.issn.0254-1424.2017.12.001

    China Expert Consensus Group on Assessment and Treatment of Swallowing Disorders Rehabilitation. Chinese expert consensus on assessment and treatment of dysphagia (2017 edition) part Ⅰ assessment part[J]. Chinese Journal of Physical Medicine and Rehabilitation, 2017, 39(12): 881-892. doi: 10.3760/cma.j.issn.0254-1424.2017.12.001
    [9]
    KWAH L K, DIONG J. National Institutes of Health stroke scale (NIHSS)[J]. J Physiother, 2014, 60(1): 61. DOI: 10.1016/j.jphys.2013.12.012.
    [10]
    ROSENBEK J C, ROBBINS J A, ROECKER E B, et al. A penetration-aspiration scale[J]. Dysphagia, 1996, 11(2): 93-98. doi: 10.1007/BF00417897
    [11]
    杜丽洁, 姜增誉, 王娇, 等. Rosenbek渗透/误吸量表在脑卒中误吸筛查中的应用[J]. 中西医结合心脑血管病杂志, 2015, 13(10): 1225-1226. doi: 10.3969/j.issn.1672-1349.2015.10.030

    DU L J, JIANG Z Y, WANG J, et al. Application of the Rosenbek Osmosis/Misinspiration Scale in screening for stroke misinspiration[J]. Chinese Journal of Integrative Medicine on Cardio/Cerebrovascular Disease, 2015, 13(10): 1225-1226. doi: 10.3969/j.issn.1672-1349.2015.10.030
    [12]
    SHUVY M, ZWAS D R, KEREN A, et al. The age-adjusted Charlson comorbidity index: a significant predictor of clinical outcome in patients with heart failure[J]. Eur J Intern Med, 2020, 73(1): 103-104. http://www.xueshufan.com/publication/3000688916
    [13]
    FRIED L P, TANGEN C M, WALSTON J, et al. Frailty in older adults: evidence for a phenotype[J]. J Gerontol A Biol Sci Med Sci, 2001, 56(3): M146-156. doi: 10.1093/gerona/56.3.M146
    [14]
    林思思, 刘天翔, 郑耳. 脑卒中吞咽障碍患者饮食自我效能及影响因素分析[J]. 中国基层医药, 2024, 31(6): 909-912. doi: 10.3760/cma.j.cn341190-20240108-00034

    LIN S S, LIU T X, ZHENG E. Analysis of dietary self-efficacy and influential factors in stroke patients with dysphagia[J]. Chinese Journal of Primary Medicine and Pharmacy, 2024, 31(6): 909-912. doi: 10.3760/cma.j.cn341190-20240108-00034
    [15]
    王国珍, 郝井兰, 张成刚. 老年急性脑梗死患者Hcy ApoB/ApoAⅠ及动态动脉硬化指数与颈动脉斑块性质的关系分析[J]. 河北医学, 2024, 30(11): 1839-1844. doi: 10.3969/j.issn.1006-6233.2024.11.015

    WANG G Z, HAO J L, ZHANG C G. Relationship between hcy ApoB/ApoA Ⅰ and ambulatory arterial stiffness index and carotid plaque properties in elderly patients with acute cerebral infarction[J]. Hebei Medicine, 2024, 30(11): 1839-1844. doi: 10.3969/j.issn.1006-6233.2024.11.015
    [16]
    王红梅, BOSOMTWE SAMUEL, 杜金磊, 等. 经口气管插管患者流涎症影响因素和干预措施的研究进展[J]. 中华全科医学, 2021, 19(12): 2102-2105. doi: 10.16766/j.cnki.issn.1674-4152.002247

    WANG H M, BOSOMTWE S, DU J L, et al. Research progress on the influencing factors and intervention measures of salivation in patients with trans-oral tracheal intubation[J]. Chinese Journal of General Practice, 2021, 19(12): 2102-2105. doi: 10.16766/j.cnki.issn.1674-4152.002247
    [17]
    刘好, 冯英璞, 陈云霞, 等. NUTRIC评分与NRS 2002在ICU老年脑卒中病人营养风险评估中的效果比较[J]. 护理研究, 2023, 37(8): 1332-1337.

    LIU H, FENG Y P, CHEN Y X, et al. Comparison of NUTRIC score and NRS 2002 in nutritional risk assessment of elderly stroke patients in ICU[J]. Chinese Nursing Research, 2023, 37(8): 1332-1337.
    [18]
    DOLEY J. Enteral nutrition overview[J]. Nutrients, 2022, 14(11): 2180. DOI: 10.3390/nu14112180.
    [19]
    ELMAHDI A, EISA M, OMER E. Aspiration pneumonia in enteral feeding: a review on risks and prevention[J]. Nutr Clin Pract, 2023, 38(6): 1247-1252. doi: 10.1002/ncp.11020
    [20]
    GIMENES F, BAYSARI M, WALTER S, et al. Are patients with a nasally placed feeding tube at risk of potential drug-drug interactions? A multicentre cross-sectional study[J]. PLoS One, 2019, 14(7): e0220248. DOI: 10.1371/journal.pone.0220248.
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