Objective

To investigate the prognostic significance of videofluorographic swallowing study (VFSS)-confirmed oropharyngeal dysphagia in idiopathic inflammatory myopathies (IIMs).

Method

We reviewed the medical records of patients who were diagnosed with IIM between 2009 and 2020 at Seoul St Mary’s Hospital. All oropharyngeal dysphagia cases were limited to VFSS-confirmed dysphagia found during the initial diagnostic work-up for IIM. We described the findings on VFSS and the course of the dysphagic symptoms. Logistic regression and survival analyses were performed to evaluate the risk of pneumonia and mortality, respectively.

Results

We found 88 patients with IIM who met the criteria. Among them, 17 patients (19%) had oropharyngeal dysphagia. Except for two cases lost to follow-up and one deceased case, all of the patients with dysphagia (14 of 14) had swallowing function restored within 6 months. The risk of pneumonia within 3 months from the diagnosis of IIM was significant [odds ratio = 4.49, 95% confidence interval (CI) 1.07–18.88]. The median follow-up duration was 34 and 27 months for the groups without and with dysphagia, respectively. The survival analysis failed to demonstrate that the presence of oropharyngeal dysphagia increased the risk of death (hazard ratio = 0.77, 95% CI: 0.085–7.00).

Conclusions

Oropharyngeal dysphagia found at the initial diagnosis of IIM improved within 3–6 months in nearly all cases. Furthermore, IIM patients who had oropharyngeal dysphagia at the initial diagnosis of IIM were not likely to have shorter survival, even if the risk of pneumonia was increased in the short term.

中文翻译：

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重新评估口咽吞咽困难在特发性炎症性肌病中的预后意义

客观的

调查视频荧光吞咽研究 (VFSS) 证实的口咽吞咽困难在特发性炎症性肌病 (IIM) 中的预后意义。

方法

我们审查了 2009 年至 2020 年间在首尔圣玛丽医院被诊断为 IIM 的患者的病历。所有口咽部吞咽困难病例仅限于在 IIM 初始诊断检查期间发现的经 VFSS 证实的吞咽困难。我们描述了 VFSS 的发现和吞咽困难症状的过程。进行逻辑回归和生存分析以分别评估肺炎和死亡率的风险。

结果

我们发现了 88 名符合标准的 IIM 患者。其中，17例（19%）患者存在口咽部吞咽困难。除 2 例失访和 1 例死亡外，所有吞咽困难患者（14 例中的 14 例）均在 6 个月内恢复了吞咽功能。IIM 诊断后 3 个月内发生肺炎的风险显着 [比值比 = 4.49，95% 置信区间 (CI) 1.07–18.88]。无吞咽困难组和无吞咽困难组的中位随访时间分别为 34 个月和 27 个月。生存分析未能证明口咽部吞咽困难的存在会增加死亡风险（风险比 = 0.77，95% CI：0.085–7.00）。

结论

在最初诊断 IIM 时发现的口咽吞咽困难在几乎所有病例中都在 3-6 个月内得到改善。此外，初始诊断为 IIM 时存在口咽部吞咽困难的 IIM 患者即使在短期内患肺炎的风险增加，其生存期也不太可能缩短。