PDF(Pubmed)
Abstract：
To date, no consensus exists on the complex clinical decision-making processes involved in oropharyngeal dysphagia, or swallowing disorders. This study aimed to develop an international consensus on a clinical decision tree for the disease trajectory of oropharyngeal dysphagia in adults, taking into account physiological impairments of swallowing, risk factors for the development of complications from oropharyngeal dysphagia, and prognostic factors for treatment outcomes. Using the Delphi technique, consensus was achieved among dysphagia experts across 31 countries, resulting in a total of 10 physiological impairments, 23 risk factors and 21 prognostic factors identified as relevant factors in the clinical decision-making process. Factors most contributing to the severity of oropharyngeal dysphagia were \'Aspiration\', \'Incomplete ejection or failure to eject aspirated materials from the airways\', \'Weak or absent cough\', \'Choking\' and \'Sensory deficits in the oropharynx\'. To connect the existing theoretical framework to clinical practice, future research will develop the current findings by corroborating the domains based on relevant factors for clinical decision making and those that contribute to the severity of oropharyngeal dysphagia.
摘要：
迄今为止,关于口咽吞咽困难的复杂临床决策过程没有共识，或吞咽障碍。这项研究旨在就成人口咽吞咽困难的疾病轨迹的临床决策树达成国际共识，考虑到吞咽的生理损伤，口咽吞咽困难并发症发展的危险因素，治疗结果的预后因素。使用Delphi技术，31个国家的吞咽困难专家达成了共识，导致总共10个生理损伤，23个危险因素和21个预后因素被确定为临床决策过程中的相关因素。导致口咽吞咽困难严重程度的因素是“误吸”，\'不完全喷射或未能从气道喷射吸入的物质\',\'咳嗽无力或无咳嗽\',\'窒息\'和\'口咽感觉缺陷\'。为了将现有的理论框架与临床实践联系起来，未来的研究将通过证实基于临床决策相关因素的领域以及导致口咽吞咽困难严重程度的领域来发展当前的发现.
