Quantitative risk factor analysis of postoperative dysphagia after anterior cervical discectomy and fusion (acdf) using the eating assessment tool-10 (eat-10)

Andrew Y. Yew, Matthew T. Nguyen, Wellington K Hsu, Alpesh A Patel*

*Corresponding author for this work

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Study Design.A retrospective case series.Objective.The aim of this study was to utilize the Eating Assessment Tool-10 (EAT-10) to quantitatively analyze risk factors contributing to dysphagia after anterior cervical discectomy and fusion (ACDF).Summary of Background Data.ACDF is one of the most common procedures performed in the United States, with postoperative dysphagia rates ranging from 2% to 60%. The EAT-10 is a self-Administered, symptom-specific 10-item clinical instrument to document dysphagia symptom severity and has demonstrated excellent internal consistency, test-retest reliability, and criterion-based validity.Methods.This study utilized a retrospective chart review of 163 patients from July 2013 to October 2017 who underwent ACDF at a single institution and prospectively completed EAT-10 surveys pre-and postoperatively. EAT-10 scores were collected preoperatively and at postoperative day 1, day 14, 1 month, 3 months, 6 months, and 12 months. Preselected risk factors were abstracted from the patients' chart. Univariate analyses were performed to identify candidate variables that correlated with abnormal EAT-10 scores at each time point. Multivariate logistic regression was then utilized to identify risk factors that were independently correlated with abnormal EAT-10 scores at each time point.Results.Female gender, younger patients, and increased operating room (OR) time was associated with increased rates of dysphagia in the early postoperative period. History of obstructive sleep apnea, history of asthma, increased American Society of Anesthesiologists (ASA) score, and a larger number of spinal levels included in the surgery were correlated with increased dysphagia in the later postoperative periods.Conclusion.Dysphagia is common following ACDF. Factors associated with longer-Term dysphagia seem to be more associated with pre-existing medical comorbidities. Understanding risk factors that correlate with increased rates of dysphagia has the potential to improve preoperative patient counseling and changes in operative management.Level of Evidence: 4.

Original languageEnglish (US)
Pages (from-to)E82-E88
JournalSpine
Volume44
Issue number2
DOIs
StatePublished - Jan 15 2019

Fingerprint

Diskectomy
Deglutition Disorders
Statistical Factor Analysis
Eating
Postoperative Period
Obstructive Sleep Apnea
Operating Rooms
Reproducibility of Results
Comorbidity
Counseling
Asthma
Logistic Models

Keywords

  • ACDF
  • EAT-10
  • cervical spine
  • discectomy
  • dysphagia
  • fusion
  • patient reported outcomes
  • postoperative complication
  • risk factor
  • spine surgery

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Clinical Neurology

Cite this

@article{a8de3024f1164a55867e1286218b2136,
title = "Quantitative risk factor analysis of postoperative dysphagia after anterior cervical discectomy and fusion (acdf) using the eating assessment tool-10 (eat-10)",
abstract = "Study Design.A retrospective case series.Objective.The aim of this study was to utilize the Eating Assessment Tool-10 (EAT-10) to quantitatively analyze risk factors contributing to dysphagia after anterior cervical discectomy and fusion (ACDF).Summary of Background Data.ACDF is one of the most common procedures performed in the United States, with postoperative dysphagia rates ranging from 2{\%} to 60{\%}. The EAT-10 is a self-Administered, symptom-specific 10-item clinical instrument to document dysphagia symptom severity and has demonstrated excellent internal consistency, test-retest reliability, and criterion-based validity.Methods.This study utilized a retrospective chart review of 163 patients from July 2013 to October 2017 who underwent ACDF at a single institution and prospectively completed EAT-10 surveys pre-and postoperatively. EAT-10 scores were collected preoperatively and at postoperative day 1, day 14, 1 month, 3 months, 6 months, and 12 months. Preselected risk factors were abstracted from the patients' chart. Univariate analyses were performed to identify candidate variables that correlated with abnormal EAT-10 scores at each time point. Multivariate logistic regression was then utilized to identify risk factors that were independently correlated with abnormal EAT-10 scores at each time point.Results.Female gender, younger patients, and increased operating room (OR) time was associated with increased rates of dysphagia in the early postoperative period. History of obstructive sleep apnea, history of asthma, increased American Society of Anesthesiologists (ASA) score, and a larger number of spinal levels included in the surgery were correlated with increased dysphagia in the later postoperative periods.Conclusion.Dysphagia is common following ACDF. Factors associated with longer-Term dysphagia seem to be more associated with pre-existing medical comorbidities. Understanding risk factors that correlate with increased rates of dysphagia has the potential to improve preoperative patient counseling and changes in operative management.Level of Evidence: 4.",
keywords = "ACDF, EAT-10, cervical spine, discectomy, dysphagia, fusion, patient reported outcomes, postoperative complication, risk factor, spine surgery",
author = "Yew, {Andrew Y.} and Nguyen, {Matthew T.} and Hsu, {Wellington K} and Patel, {Alpesh A}",
year = "2019",
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Quantitative risk factor analysis of postoperative dysphagia after anterior cervical discectomy and fusion (acdf) using the eating assessment tool-10 (eat-10). / Yew, Andrew Y.; Nguyen, Matthew T.; Hsu, Wellington K; Patel, Alpesh A.

In: Spine, Vol. 44, No. 2, 15.01.2019, p. E82-E88.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Quantitative risk factor analysis of postoperative dysphagia after anterior cervical discectomy and fusion (acdf) using the eating assessment tool-10 (eat-10)

AU - Yew, Andrew Y.

AU - Nguyen, Matthew T.

AU - Hsu, Wellington K

AU - Patel, Alpesh A

PY - 2019/1/15

Y1 - 2019/1/15

N2 - Study Design.A retrospective case series.Objective.The aim of this study was to utilize the Eating Assessment Tool-10 (EAT-10) to quantitatively analyze risk factors contributing to dysphagia after anterior cervical discectomy and fusion (ACDF).Summary of Background Data.ACDF is one of the most common procedures performed in the United States, with postoperative dysphagia rates ranging from 2% to 60%. The EAT-10 is a self-Administered, symptom-specific 10-item clinical instrument to document dysphagia symptom severity and has demonstrated excellent internal consistency, test-retest reliability, and criterion-based validity.Methods.This study utilized a retrospective chart review of 163 patients from July 2013 to October 2017 who underwent ACDF at a single institution and prospectively completed EAT-10 surveys pre-and postoperatively. EAT-10 scores were collected preoperatively and at postoperative day 1, day 14, 1 month, 3 months, 6 months, and 12 months. Preselected risk factors were abstracted from the patients' chart. Univariate analyses were performed to identify candidate variables that correlated with abnormal EAT-10 scores at each time point. Multivariate logistic regression was then utilized to identify risk factors that were independently correlated with abnormal EAT-10 scores at each time point.Results.Female gender, younger patients, and increased operating room (OR) time was associated with increased rates of dysphagia in the early postoperative period. History of obstructive sleep apnea, history of asthma, increased American Society of Anesthesiologists (ASA) score, and a larger number of spinal levels included in the surgery were correlated with increased dysphagia in the later postoperative periods.Conclusion.Dysphagia is common following ACDF. Factors associated with longer-Term dysphagia seem to be more associated with pre-existing medical comorbidities. Understanding risk factors that correlate with increased rates of dysphagia has the potential to improve preoperative patient counseling and changes in operative management.Level of Evidence: 4.

AB - Study Design.A retrospective case series.Objective.The aim of this study was to utilize the Eating Assessment Tool-10 (EAT-10) to quantitatively analyze risk factors contributing to dysphagia after anterior cervical discectomy and fusion (ACDF).Summary of Background Data.ACDF is one of the most common procedures performed in the United States, with postoperative dysphagia rates ranging from 2% to 60%. The EAT-10 is a self-Administered, symptom-specific 10-item clinical instrument to document dysphagia symptom severity and has demonstrated excellent internal consistency, test-retest reliability, and criterion-based validity.Methods.This study utilized a retrospective chart review of 163 patients from July 2013 to October 2017 who underwent ACDF at a single institution and prospectively completed EAT-10 surveys pre-and postoperatively. EAT-10 scores were collected preoperatively and at postoperative day 1, day 14, 1 month, 3 months, 6 months, and 12 months. Preselected risk factors were abstracted from the patients' chart. Univariate analyses were performed to identify candidate variables that correlated with abnormal EAT-10 scores at each time point. Multivariate logistic regression was then utilized to identify risk factors that were independently correlated with abnormal EAT-10 scores at each time point.Results.Female gender, younger patients, and increased operating room (OR) time was associated with increased rates of dysphagia in the early postoperative period. History of obstructive sleep apnea, history of asthma, increased American Society of Anesthesiologists (ASA) score, and a larger number of spinal levels included in the surgery were correlated with increased dysphagia in the later postoperative periods.Conclusion.Dysphagia is common following ACDF. Factors associated with longer-Term dysphagia seem to be more associated with pre-existing medical comorbidities. Understanding risk factors that correlate with increased rates of dysphagia has the potential to improve preoperative patient counseling and changes in operative management.Level of Evidence: 4.

KW - ACDF

KW - EAT-10

KW - cervical spine

KW - discectomy

KW - dysphagia

KW - fusion

KW - patient reported outcomes

KW - postoperative complication

KW - risk factor

KW - spine surgery

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