Abstract
INTRODUCTION: To predict the onset of dysphagia in hospitalized patients with osteoporotic vertebral fractures (OVF) early after admission and to investigate cutoff values for risk factors. METHODS: The subjects were 341 hospitalized patients with OVF. We excluded 30 cases as the required data could not be measured, and 25 cases with conditions that could contribute to dysphagia, such as neurological or respiratory comorbidities. Gender, age, number and level of OVF, collapse rate (CR) of OVF, thoracolumbar kyphosis angle (KA), bone mineral density (BMD), systemic skeletal muscle mass index (SMI), and body mass index (BMI) were examined by dividing the patients into those with dysphagia (the P group) and others (the N group). RESULTS: There were 26 cases in the P group and 260 cases in the N group, with no significant difference in the male-female ratio, number, and level of OVF. The mean values of CR (%), KA in the P group/the N group were 40.0/36.1, 16.7/17.8, and the mean values of age, BMD (%), SMI (kg/m(2)), and BMI (kg/m(2)) in the P group/the N group were 86.4/82.3, 64.5/71.6, 4.43/5.58, 20.0/22.1 in men, 85.7/83.4, 55.1/63.8, 4.43/4.99, 19.4/21.6 in women, with significant differences in SMI in men and women and BMD in women. Analysis of SMI and BMD in women using a multivariate logistic model with dysphagia as the dependent variable showed that low SMI was an independent risk factor. The cutoff value, sensitivity, specificity, and area under the receiver operating characteristic curve for SMI were calculated. For men, the values were 4.610 kg/m(2), 0.867, 0.750, and 0.829, respectively, and for women, 4.410 kg/m(2), 0.790, 0.571, and 0.687, respectively. CONCLUSIONS: A correlation was found between dysphagia and SMI in patients with OVF. For patients with SMI below the cutoff value, early swallowing evaluation and training intervention are considered important.