Development of predictive score for postoperative dysphagia after emergency abdominal surgery in patients of advanced age.

Aim: Postoperative dysphagia after emergency abdominal surgery (EAS) in patients of advanced age has become problematic, and appropriate dysphagia management is needed. This study was performed to identify predictive factors of dysphagia after EAS and to explore the usefulness of swallowing screening tools (SSTs). Methods: This retrospective study included 267 patients of advanced age who underwent EAS from 2012 to 2022. They were assigned to a dysphagia group and non‐dysphagia group using the Food Intake Level Scale (FILS) (dysphagia was defined as a FILS level of <7 on postoperative day 10). From 2018, original SSTs including a modified water swallowing test were performed by nurses. Results: The incidence of postoperative dysphagia was 22.8% (61/267). Patients were significantly older in the dysphagia than non‐dysphagia group. The proportions of patients who had poor nutrition, cerebrovascular disorder, Parkinson's disease, dementia, nursing‐care service, high intramuscular adipose tissue content (IMAC), and postoperative ventilator management were much higher in the dysphagia than non‐dysphagia group. Using logistic regression analysis, high IMAC, postoperative ventilator management, cerebrovascular disorder, and dementia were correlated with postoperative dysphagia and were assigned 10, 4, 3, and 3 points, respectively, according to each odds ratio. The optimal cut‐off value was 7 according to a receiver operating characteristics curve. Using 1:1 propensity score matching for high‐risk patients, the incidence of postoperative dysphagia was reduced by SSTs. Conclusions: The new prediction score obtained from this study can identify older patients at high risk for dysphagia after EAS, and SSTs may improve these patients' short‐term outcomes. This retrospective study included 267 patients of advanced age and was performed to identify predictive factors of dysphagia after emergency abdominal surgery and to explore the usefulness of swallowing screening tools. This study demonstrated that high intramuscular adipose tissue content, postoperative ventilator management, cerebrovascular disorder, and dementia were associated with postoperative dysphagia after emergency abdominal surgery in patients of advanced age. For patients at high risk as identified by our new prediction score that was created based on these risk factors, propensity score‐matching analysis showed that the use of swallowing screening tools can help to prevent postoperative dysphagia. [ABSTRACT FROM AUTHOR]