开发用于筛查住院老年人疑似吞咽困难的EAT-10三项简表：一项多中心研究的结果
Development of a three-item short form of the EAT-10 for screening suspected dysphagia in hospitalized older adults: findings from a multicentre study.
文献信息
| PMID | 42755518 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | María Trinidad Castillo-García |
| 作者单位 | Dr. Balmis University General Hospital, Institute for Health and Biomedical Research (ISABIAL, Group 20), Alicante, Spain. |
| 期刊 | Frontiers in nutrition |
| SCI 分区 | Q1 |
| IF | 6.1 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 咽喉科 |
中文摘要
目的： 通过识别能够保留完整问卷在住院老年人中筛查性能的最小条目子集，开发EAT-10的三项简表。
设计： 多中心横断面观察性研究。
方法： 该研究在西班牙九家公立医院内作为NUTRIFAG项目的一部分开展。纳入年龄≥65岁且住院时间≥48小时的住院患者。排除入院时接受肠内或肠外营养的患者、终末期患者或主要诊断为癌症的患者。使用进食评估工具（EAT-10）评估疑似吞咽困难，评分≥3视为阳性。采用前向条目选择的多因素logistic回归模型识别信息量最大的症状指标。样本被随机分为训练子集（60%）和内部评估子集（40%）。使用Nagelkerke伪R²、Hosmer-Lemeshow检验、灵敏度、特异度和受试者工作特征曲线下面积（AUC）评估模型性能。
结果： 样本包括2,519名参与者。三个症状指标在识别疑似吞咽困难患者方面信息量最大：吞咽液体需要额外用力、吞咽固体需要额外用力以及进食时咳嗽。这些指标共同显示，在训练阶段与使用完整EAT-10所得分类高度一致（R²=0.861；灵敏度=0.863；特异度=0.979；AUC=0.982），在内部评估子集中具有相似的分类性能（灵敏度=0.881；特异度=0.984）。
结论： 所提出的三项子集代表了EAT-10的缩短版本，在住院老年人中保留了完整问卷的大部分筛查性能。尽管它可能通过在常规护理评估中重现完整EAT-10所得分类来促进吞咽困难筛查，但在推荐其用于诊断之前，需要针对临床参考标准进行独立的外部验证。
英文摘要
AIM: To develop a three-item short form of the EAT-10 by identifying the smallest subset of items that preserves the screening performance of the full questionnaire in hospitalized older adults.
DESIGN: Multicentre cross-sectional observational study.
METHODS: The study was conducted in nine public hospitals in Spain within the NUTRIFAG project. Hospitalized patients aged ≥65 years with a length of stay ≥48 h were included. Patients receiving enteral or parenteral nutrition at admission, those in terminal condition, or with a primary diagnosis of cancer were excluded. Suspected dysphagia was assessed using the Eating Assessment Tool (EAT-10), with a score ≥3 considered positive. Multivariate logistic regression models with forward item selection were used to identify the most informative symptoms indicators. The sample was randomly divided into a training subset (60%) and an internal assessment subset (40%). Model performance was evaluated using Nagelkerke's pseudo R 2, the Hosmer-Lemeshow test, sensitivity, specificity, and the area under the receiver operating characteristic curve (AUC).
RESULTS: The sample included 2,519 participants. Three symptom indicators emerged as the most informative for identifying patients with suspected dysphagia: requiring extra effort to swallow liquids, requiring extra effort to swallow solids, and coughing while eating. Together, these indicators showed high agreement with the classification obtained using the full EAT-10 in the training phase (R 2 = 0.861; sensitivity = 0.863; specificity = 0.979; AUC = 0.982), which similar classification performance in the internal assessment subset (sensitivity = 0.881; specificity = 0.984).
CONCLUSION: The proposed three-item subset represents a shortened version of the EAT-10 that preserved much of the screening performance of the full questionnaire in hospitalized older adults. Although it may facilitate dysphagia screening by reproducing the classification obtained with the full EAT-10 in routine nursing assessment, independent external validation against clinical reference standards is required before its diagnostic use can be recommended.