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The Japanese Journal of Rehabilitation Medicine Volume 58, Issue 11 （November 2021）

The Japanese Journal of Rehabilitation Medicine 58巻11号（2021年11月発行）

Japanese English

原著

嚥下障害および経口摂取と改定口腔アセスメントガイドを用いた口腔内環境との関係 Relationship between Dysphagia or Oral Intake and Oral Status Using the Revised Oral Assessment Guide 松尾宏 ¹ Hiroshi Matsuo ¹ ¹松阪中央総合病院リハビリテーション科 ¹Department of Rehabilitation, Matsusaka Chuo General Hospital キーワード：嚥下障害 , dysphagia , 経口摂取 , oral intake , 改定口腔アセスメントガイド , Revised Oral Assessment Guide Keyword: 嚥下障害 , dysphagia , 経口摂取 , oral intake , 改定口腔アセスメントガイド , Revised Oral Assessment Guide pp.1291-1297

発行日 2021年11月18日 Published Date 2021/11/18

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Abstract 文献概要
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参考文献 Reference

要旨

目的：改定口腔アセスメントガイド（Revised Oral Assessment Guide：ROAG）は口腔内環境をスクリーニング評価するものの1つだが，それが嚥下障害や経口摂取に関係あるか否かを直接調べた研究はこれまでにない．本研究はそのような関係があるかを診療録から後方視的に分析した．

方法：対象は，2019年10月〜2020年3月に当院に入院し，主科から嚥下検査依頼があり，嚥下検査を施行できた患者88人とした．嚥下造影検査か嚥下内視鏡検査を行い，臨床的重症度分類（Dysphagia Severity Scale：DSS）を用いて嚥下障害の重症度を判定した．ROAGに関しては，病棟看護師が入院から退院まで毎週行った．これらの結果をもとにROAGと嚥下障害や経口摂取との関係を統計解析した．

結果：入院時ROAG合計点とDSSとの有意な関係が明らかとなった．入院時ROAG合計点と経口摂取とは有意な関係は認められなかった．一方，退院時ROAG合計点が入院時のそれに比べて増加（悪化）した群では，増加の大きさと経口摂取に有意な負の相関が認められ，口腔内環境が悪化するほど経口摂取は難しくなる可能性がみられた．

結語：これらの結果は，嚥下障害や経口摂取を予測するのにROAGを用いた口腔内環境評価は有用であることを示唆する．

Objective：The Revised Oral Assessment Guide (ROAG) is a screening tool for evaluating oral status. However, no study has directly investigated the relationship between ROAG and dysphagia or oral intake at discharge. Therefore, this study aimed to retrospectively analyze the presence, or absence, of such a relationship from the participants' medical records.

Methods：In total, 88 patients who were admitted to our hospital from October 2019 to March 2020 and underwent swallowing tests after consultations with attending physicians were enrolled in the study. The degree of dysphagia was evaluated using the Dysphagia Severity Scale (DSS) after carrying out video fluoroscopy or fiberoptic endoscopic evaluation of swallowing. ROAG was performed weekly by a ward nurse, from the time of admission to discharge. Based on the results of the tests, the relationship between ROAG and dysphagia or oral intake was statistically analyzed.

Results：A significant relationship was revealed between the ROAG score at admission and DSS. No significant relationship was found between ROAG score at admission and oral intake at discharge. On the other hand, in the group in which ROAG score at discharge increased (deteriorated) compared to that at admission, a significant negative correlation was observed between the degree of the ROAG increase and oral intake at discharge. This implied that deterioration of the oral status may possibly lead to difficulty in oral intake.

Conclusion：These results suggest that the ROAG-based oral status assessment is useful for predicting dysphagia or oral intake in patients admitted to an acute care hospital.