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Impact of Presarcopenic Dysphagia on 1-Year Mortality After Videofluoroscopic Swallowing Study in Patients with Cancer

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Abstract

Sarcopenic dysphagia is the term for swallowing difficulty associated with loss of mass, strength, and physical performance, which leads to increased pharyngeal residues. Unlike sarcopenia, presarcopenia is characterized by low muscle mass without decreased muscle strength or physical performance and can develop into dysphagia due to low skeletal muscle mass. This retrospective study investigated the impact of presarcopenic dysphagia (PSD) on 1-year mortality in patients with cancer and dysphagia who underwent a videofluoroscopic swallowing study (VFSS). An operational definition of PSD based on presarcopenia and pharyngeal residues was adopted. The psoas muscle mass index (cm2/height [m2]), calculated by the psoas muscle area at the third lumber vertebra via abdominal computed tomography (CT) and related to height, was used to assess presarcopenia with cutoff values of 4.62 for men and 2.66 for women. Pharyngeal residues were assessed using a VFSS to evaluate dysphagia. Patients’ medical charts were analyzed to investigate 1-year mortality after a VFSS. Out of 111 consecutive patients with cancer, 53 (47.7%) were defined as having PSD. In a forward-stepwise Cox proportional regression analysis, PSD (HR 2.599; 95% CI 1.158–5.834; p = 0.021) was significantly associated with 1-year mortality after a VFSS, even after adjusting for the factors of operation, Functional Oral Intake Scale (FOIS) scores at discharge, and modified Barthel Index (BI) scores at discharge. PSD, defined as CT-based presarcopenia and pharyngeal residues observed during a VFSS, is associated with increased 1-year mortality in patients with cancer and dysphagia.

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All data are not publically available owing to opt-out restrictions. Data sharing is not applicable.

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Funding

This study was not financially supported.

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Authors and Affiliations

  1. Department of Rehabilitation Medicine, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanisihi-Ku, Kitakyushu, Fukuoka, 807, Japan

    Toshiyuki Moriyama, Akiko Hachisuka, Yasuyuki Matsusihima, Mizuki Tokunaga, Ryoko Hori, Hiroyuki Tashima, Hideaki Itoh, Mitsuhiro Ochi & Satoru Saeki

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  1. Toshiyuki Moriyama
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  2. Akiko Hachisuka
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  3. Yasuyuki Matsusihima
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Contributions

TM conceived the idea of the study, developed the statistical analyses, and drafted the original manuscript on intellectual content. AH and YM contributed to interpreting the results and revised the original manuscript. MT, RH, HT, HI, and MO contributed to collecting the data for the study. SS supervised the conduct of the study. All Authors reviewed the manuscript draft and approved publishing the final version.

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Correspondence to Toshiyuki Moriyama.

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The authors declare no conflict of interest.

Ethical Approval

This study was conducted under the Declaration of Helsinki and with the approval of the Ethics Committee of the University Hospital of Occupational and Environmental Health, Japan [UOEHCRB22-144]. Written informed consent was not obtained because of the retrospective observational nature of the study. Nevertheless, all patients were allowed to provide an opt-out option to withdraw from the study at any time.

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Moriyama, T., Hachisuka, A., Matsusihima, Y. et al. Impact of Presarcopenic Dysphagia on 1-Year Mortality After Videofluoroscopic Swallowing Study in Patients with Cancer. Dysphagia (2024). https://doi.org/10.1007/s00455-023-10652-4

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