Relação entre risco de disfagia e nível de ingestão oral em pacientes oncológicos
Relation between risk of dysphagia and oral intake level in cancer patients
Alexia Diovana Fernandes da Rocha; Monalise Costa Batista Berbert; Vera Beatris Martins
Resumo
Palavras-chave
Abstract
Objective To relate the self-perceived risk of dysphagia with the level of oral intake in hospitalized oncology patients.
Methods This cross-sectional study had a convenience sample of adults and older adults diagnosed with cancer and hospitalized in an oncology hospital in southern Brazil. Data on sex, age, length of hospitalization, comorbidities, oncological diagnosis, treatment, and feeding route were obtained from the participants' medical records. The level of oral intake was classified using the Functional Oral Intake Scale (FOIS), and the risk of dysphagia was identified using the Eating Assessment Tool (EAT-10). The relationship between these variables was analyzed using Spearman's correlation coefficient.
Results The study included 60 participants – 42 with solid tumors and 18 with hematological tumors; 35 females (58.3%) and 25 males(41.7%), with a mean age of 58.5 ± 13.1 years. Of these, 56 exclusively used the oral route for feeding (93.3%), and 18 were at risk of dysphagia (30%). Older patients were at higher risk for dysphagia than adults (p-value = 0.020). EAT-10 scores (median = 0; IQR = 0–4) were significantly inversely correlated (RHO = -0.463; p-value = 0.000) with FOIS classifications (N: level 2 = 2; level 3 = 2; level 4 = 2; level 5 = 12; level 7 = 42).
Conclusion The study found that lower EAT-10 scores corresponded to higher FOIS levels. In other words, the lower the risk of dysphagia, the lower the susceptibility to using alternative feeding routes.
Keywords
Referências
1 INCA: Instituto Nacional de Câncer. Estimativa 2023: incidência de câncer no Brasil [Internet]. Rio de Janeiro: INCA; 2022 [citado em 2024 Abr 1]. Available from:
2 Frowen J. Dysphagia in patients with non-head and neck cancer. Otolaryngol Head Neck Surg. 2019;27(3):162-7.
3 Raber-Durlacher JE, Brennan MT, Verdonck-de Leeuw IM, Gibson RJ, Eilers JG, Waltimo T, et al. Swallowing dysfunction in cancer patients. Support Care Cancer. 2012;20(3):433-43.
4 Okuni I, Otsubo Y, Ebihara S. Molecular and neural mechanism of dysphagia due to cancer. Int J Mol Sci. 2021;22(13):7033.
5 Printza A, Kyrgidis A, Pavlidou E, Triaridis S, Constantinidis J. Reliability and validity of the Eating Assessment Tool-10 (Greek adaptation) in neurogenic and head and neck cancer-related oropharyngeal dysphagia. Eur Arch Otorhinolaryngol. 2018;275(7):1861-8.
6 Arrese LC, Carrau R, Plowman EK. Relationship between the eating assessment Tool-10 and objective clinical ratings of swallowing function in individuals with head and neck cancer. Dysphagia. 2017;32(1):83-9.
7 Etges CL, Scheeren B, Gomes E, Barbosa LDR. Screening tools for dysphagia: a systematic review. CoDAS. 2014;26(5):343-9.
8 Arrese LC, Schieve HJ, Graham JM, Stephens JA, Carrau RL, Plowman EK. Relationship between oral intake, patient perceived swallowing impairment, and objective videofluoroscopic measures of swallowing in patients with head and neck cancer. Head Neck. 2019;41(4):1016-23.
9 Sinn FS, Charters E, Stone D, Janabi M, Bogaardt H. Responsiveness of the EAT-10 to clinical change in head and neck cancer patients with dysphagia. Int J Speech Lang Pathol. 2020;22(1):78-85.
10 Florie M, Pilz W, Kremer B, Verhees F, Waltman G, Winkens B, et al. EAT-10 scores and fiberoptic endoscopic evaluation of swallowing in head and neck cancer patients. Laryngoscope. 2021;131(1):E45-51. PMid:32246779.
11 Ishii R, Kato K, Ohkoshi A, Sato T, Hirano A, Ogawa T, et al. Simultaneous evaluation of symptoms, swallowing functions, and patient-reported swallowing difficulties and their correlations with ingestion status during definitive chemoradiotherapy for oropharyngeal and hypopharyngeal cancer. Support Care Cancer. 2021;29(2):955-64.
12 Crary MA, Carnaby-Mann GD, Groher ME. Initialpsychometric assessment of a functional oral intakescale for dysphagia in strokepatients. Arch Phys Med Rehabil. 2005;86(8):1516-20.
13 Belafsky PC, Mouadeb DA, Rees CJ, Pryor JC, Postma GN, Allen J, et al. Validity and reliability of the Eating Assessment Tool (EAT-10). Ann Otol Rhinol Laryngol. 2008;117(12):919-24.
14 Gonçalves MIR, Remaili CB, Behlau M. Cross-cultural adaptation of the Brazilian version of the Eating Assessment Tool - EAT-10. CoDAS. 2013;25(6):601-4.
15 Chiu YH, Tseng WH, Ko JY, Wang TG. Radiation-induced swallowing dysfunction in patients with head and neck cancer: a literature review. J Formos Med Assoc. 2022;121(1 Pt 1):3-13.
16 Frowen J, Hughes R, Skeat J. The prevalence of patient-reported dysphagia and oral complications in cancer patients. Support Care Cancer. 2020;28(3):1141-50.
17 Portas J, Corrêa D, Queija D, Arantes LMRB, Viana LDS, Carvalho AL. Effect of induction chemotherapy on swallowing in head and neck cancer patients. Asian Pac J Cancer Prev. 2019;20(1):91-6.
18 Dewan K. Chemotherapy and dysphagia: the good, the bad, the ugly. Curr Opin Otolaryngol Head Neck Surg. 2020;28(6):385-91.
19 Sadaps M, Bhatt A, Chevalier C, Sohal D, Videtic G, McNamara MJ. A practical guide to the management of dysphagia in patients with metastatic esophageal cancer. AOE. 2018;1:2616-784.
20 Chow R, Bruera E, Arends J, Walsh D, Strasser F, Isenring E, et al. Enteral and parenteral nutrition in cancer patients, a comparison of complication rates: an updated systematic review and (cumulative) meta-analysis. Support Care Cancer. 2020;28(3):979-1010.
21 Martinovic D, Tokic D, Puizina Mladinic E, Usljebrka M, Kadic S, Lesin A, et al. Nutritional management of patients with head and neck cancer-a comprehensive review. Nutrients. 2023;15(8):1864.
22 Zambrano TBS, Batista C, Poletto AC, Gavilanes N, Guskuma MH, do Amaral MA, et al. Oral hygiene of patients with cancer in the intensive care unit. J. Health Scie. 2018;20(2):83-6.
23 Epstein JB, Barasch A. Oral and dental health in head and neck cancer patients. Cancer Treat Res. 2018;174:43-57.
24 Kenny C, Regan J, Balding L, Higgins S, O’Leary N, Kelleher F, et al. Dysphagia prevalence and predictors in cancers outside the head, neck, and upper gastrointestinal tract. J Pain Symptom Manage. 2019;58(6):949-958.e2.
25 Leão I, Garcia C, Antunes P, Campolargo A, Dias I, Coimbra E, et al. Dysphagia prevalence and predictors in cancers outside the head, neck, and upper gastrointestinal tract. Cancers. 2022;14(11):2698. PMid:35681678.
26 Matsuda Y, Karino M, Kanno T. Relationship between the Functional Oral Intake Scale (FOIS) and the Self-Efficacy Scale among Cancer Patients: a cross-sectional study. Healthcare. 2020;8(3):269.
27 Souza LF, Nascimento WV, Alves LMT, Silva ACV, Cassiani RA, Alves DC, et al. Medicationswallowingdifficulties in peoplewithoutdysphagia. Rev CEFAC. 2019;21(4):e0119.
28 Radhakrishnan C, Sefidani Forough A, Cichero JAY, Smyth HE, Raidhan A, Nissen LM, et al. A difficult pill to swallow: an investigation of the factors associated with medication swallowing difficulties. Patient Prefer Adherence. 2021;15:29-40.
29 Tahaineh L, Wazaify M. Difficulties in swallowing oral medications in Jordan. Int J Clin Pharm. 2017;39(2):373-9.
30 Abu-Ghanem S, Chen S, Amin MR. Oropharyngeal dysphagia in the elderly: evaluation and prevalence. Curr Otorhinolaryngol Rep. 2020;8(1):34-42.
31 Thiyagalingam S, Kulinski AE, Thorsteinsdottir B, Shindelar KL, Takahashi PY. Dysphagia in older adults. Mayo Clin Proc. 2021;96(2):488-97.
32 Andrade PA, Santos CAD, Firmino HH, Rosa COB. The importance of dysphagia screening and nutritional assessment in hospitalized patients. Einstein. 2018;16(2):eAO4189. PMid:29898087.
33 Huh G, Ahn SH, Suk JG, Lee MH, Kim WS, Kwon SK, et al. Severe late dysphagia after multimodal treatment of stage III/IV laryngeal and hypopharyngeal cancer. Jpn J Clin Oncol. 2020;50(2):185-92.
Submetido em:
01/04/2024
Aceito em:
05/08/2024
Facebook
Google+
Twitter
LinkedIn
Mendeley
StumbleUpon
CiteULike
Reddit
Email