Videoendoscopic Evaluation of Swallowing in Patients with Active Pulmonary Tuberculosis：A Retrospective Study / The Japanese Journal of Rehabilitation Medicine

ABSTRACT

Purpose：In recent years, the proportion of older people diagnosed with lung tuberculosis is increasing in Japan. There have been no previous reports on detailed evaluation of swallowing function in patients with pulmonary tuberculosis. This study aimed to retrospectively evaluate the severity and characteristics of dysphagia using videoendoscopic evaluation of swallowing (VE) in patients with lung tuberculosis.Methods：A total of 58 patients (average age, 85.2 years) were selected. They are diagnosed with active pulmonary tuberculosis and underwent VE (performed an average 23 days after admission) at our hospital between January 2017 and March 2020. The severity of dysphagia was assessed using the functional oral intake scale (FOIS)．Activities of daily living (ADL) of the patients was evaluated by using Barthel Index (BI).Results：The average body mass index of the patients was 17 kg/m2, average serum albumin was 2.3 mg/dl, and average BI score was 8.6. Approximately, 71％ of the patients showed severe dysphagia (FOIS 1-2), and BI score of the group was significantly lower than that of the moderate group (FOIS＞3). We observed residual thickened water in 76％ of the patients. Before the VE, 45％ patients were administered oral anti-tuberculosis drugs. Only 35％ of the patients continued those drugs after VE, and 45％ of the patients died in hospital.Conclusion：The results suggest that patients with pulmonary tuberculosis might have a high frequency of severe dysphagia. Appropriate method of anti-tuberculosis drug administration should be selected based on their swallowing functions.