Objective

To investigate the construct validity of the Functional Oral Intake Scale (FOIS) as a proxy measure for dysphagia, through associations with swallowing prerequisites, orofacial functions, age, and diagnosis; and to investigate content validity through distributions of FOIS ratings.

Methods

A cohort of 1,876 patients with severe acquired brain injury. Early Functional Abilities items were applied as measures of swallowing prerequisites and orofacial functions. Clustered logistic regression model with 6,052 cross-sectional observations.

Results

Disturbance in swallowing 10.55 OR (95%CI:7.90;14.09), oro-facial stimulation 3.04 OR (95%CI:2.41;3.83), and head control 2.86 OR (95%CI:2.25;3.62) were robustly associated with tube feeding (FOIS 1–3). Disturbance in trunk control, wakefulness, tongue movement/chewing, older age, and a non-stroke diagnosis were also associated with tube feeding. BMI did not attenuate associations in sensitivity analyses. FOIS ratings had greatest density in FOIS level 1 and level 7, with 25% and 40% of registrations, respectively. Level 4 was rated in only 1% of 6,052 registrations.

Conclusions

The FOIS was robustly associated with indicators of dysphagia. However, associations with postural control, wakefulness, age and diagnosis highlights that tube feeding may be attributed to other issues than dysphagia. It should be further investigated whether FOIS level 4 is meaningful in neurorehabilitation.

中文翻译：

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功能性口腔摄入量表的构建和内容效度；从获得性脑损伤患者队列中进行分析。

目的

通过与吞咽先决条件，口面功能，年龄和诊断的关联，研究功能性口腔摄入量表（FOIS）作为吞咽困难的替代指标的结构效度；并通过FOIS等级分布调查内容的有效性。

方法

1,876名患有严重后天性脑损伤的患者。早期功能能力项被用作吞咽先决条件和口腔功能的量度。具有6,052个横截面观测值的聚类逻辑回归模型。

结果

吞咽障碍与管显着相关，吞咽障碍为10.55 OR（95％CI：7.90; 14.09），口腔面部刺激3.04 OR（95％CI：2.41; 3.83）和头部控制2.86 OR（95％CI：2.25; 3.62）。喂食（FOIS 1-3）。摄食管饲也与躯干控制障碍，清醒，舌头运动/咀嚼，年龄较大和无中风诊断有关。BMI并没有减弱敏感性分析中的关联。FOIS等级在FOIS 1级和7级中密度最高，分别为注册的25％和40％。在6,052个注册中，只有4％被评为4级。

结论

FOIS与吞咽困难指标密切相关。然而，与姿势控制，清醒，年龄和诊断的相关性突出表明，管饲可能是吞咽困难以外的其他原因。FOIS 4级是否在神经康复中有意义是否应进一步研究。