喉科患者报告结局指标和人口统计学特征作为发音障碍相关手术的预测因素。

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中文摘要

目的： 患者报告结局指标（PROMs）在喉科门诊中很常用。我们假设某些PROMs和人口统计学数据可能有助于在初次检查前识别哪些发音障碍患者更可能需要由喉科医生进行手术。
方法： 本研究于2021年9月至2023年10月在一个学术医学中心喉科门诊进行。查询了一个前瞻性收集的新喉科患者数据库，纳入主诉包含发音障碍、嗓音障碍指数-10（VHI-10）、反流症状指数和声门功能指数（GFI）评分以及喉频闪镜检查后诊断的患者。对患者就诊时的年龄、性别以及随后的发音障碍相关手术（DRPs）（手术室或诊室）进行了回顾性病历审查。使用t检验/Wilcoxon秩和检验/卡方检验比较了在首次就诊后1年内接受DRP的患者（DRP+）与未接受DRP的患者之间的特征。使用逻辑回归模型识别手术的预测因素，并通过受试者工作特征曲线评估准确性。
结果： 共识别出577名发音障碍患者；174名（30.1%）为DRP+。该人群在统计学上显著年龄更大、更可能为男性、更可能仅有发音障碍主诉（CCOD），并且VHI-10和GFI评分更高。多变量分析显示，VHI-10评分、CCOD的存在（与不存在相比）以及患者性别使曲线下面积最大化（0.74；95% CI：0.70-0.78）。
结论： 较高的VHI-10评分、CCOD和男性性别可能预测新发发音障碍患者需要后续嗓音相关手术。这些数据可能有助于资源有限的嗓音门诊的初次就诊筛查和分诊。

英文摘要

OBJECTIVES: Patient-Reported Outcome Measures (PROMs) are popular in laryngology clinics. We hypothesized that certain PROMs and demographic data might identify which dysphonic patients are more likely to require a procedure by a laryngologist prior to initial examination.
METHODS: This study took place at one academic medical center laryngology clinic from September 2021 to October 2023. A prospectively collected new laryngology patient database was queried for a chief complaint inclusive of dysphonia; Vocal Handicap Index-10 (VHI-10), Reflux Symptom Index, and Glottal Function Index (GFI) scores; and a poststroboscopy diagnosis. A retrospective chart review was performed for patient age at presentation, sex, and subsequent dysphonia-related procedures (DRPs) (operating room or office). T tests /Wilcoxon rank sums/ Chi-square tests compared characteristics between patients having a DRP within 1 year of their first visit (DRP+) and patients who did not. Logistic regression models were used to identify predictors of procedure, and accuracy was assessed with receiver operator characteristic curves.
RESULTS: Five hundred seventy-seven dysphonic patients were identified; 174 (30.1%) were DRP+. This population was statistically significantly older, more likely to be male, more likely to have a chief complaint of only dysphonia (CCOD), and had greater VHI-10 and GFI scores. Multivariable analysis revealed that the VHI-10 score, the presence (versus absence) of CCOD, and patient sex maximized the area under the curve (0.74; 95% CI: 0.70-0.78).
CONCLUSION: Higher VHI-10 scores, CCOD, and male sex may be predictive of the need for subsequent voice-related procedures in new dysphonia patients. These data may be useful for initial visit screening and triage in resource-constrained voice clinics.