Validity of a Scoring System Based on Four Parameters for Videofluoroscopic Examination of Swallowing to Provide Solid Foods to Patients with Dysphagia

<p>　Aim:　The present study aimed to verify the validity of a four-parameter scoring system (VF score) for videofluoroscopic (VF) examination of swallowing to determine whether patients with dysphagia should be provided solid food.</p><p>　Patients and Methods:　The cohort included 193 patients who underwent VF at our hospital between February 2018 and February 2022. VF examinations were performed using jelly as the solid food, and swallowing function was assessed using the following four parameters: 1）oral food processing (processing movement) and tongue motion, 2) propulsion from the oral cavity to the pharynx, 3) timing of swallowing reflex initiation, and 4) pharyngeal clearance after swallowing. Each of the four parameters was scored on a scale from 0 point (normal) to 3 points (severe). We compared patients who were able to take in solid food to those who could not, and verified 11 factors that had the potential to affect solid food intake of patients with dysphagia and the four parameters of the VF score.</p><p>　Results:　We judged that the patients who could take in solid food scored better than Grade 5 on Fujishima’s Food Intake Level Scale (FILS) for dysphagia within 1 month after VF. The rate of intake of solid food decreased with increasing score for each of the four parameters. Five factors (male sex and the four parameters of the VF score) were significant outcomes for solid food intake by univariate analysis. All four parameters of the VF score were significant outcomes for solid food intake by multivariate analysis.</p><p>　Conclusions:　We confirmed the internal validity of the VF score since all four parameters of the VF score were independent risk factors for solid food intake of patients with dysphagia. We concluded that the VF score could be a quantitative and easy-to-use standard evaluation tool for VF examinations.</p>