A Retrospective Review of Clinical Characteristics and Risk Factors of Dysphagia in Patients with Dermatomyositis.
Ivy Cheng, Christina Sze Man Wong, Henry Hin Lee Chan
PMID 39514083WHAT IT FOUND
Speech therapists confirmed swallowing problems in 28 of 149 patients with dermatomyositis, and 6 of them had silent aspiration.
Older age, shorter disease duration, cancer and use of prednisolone or IVIg were associated with dysphagia.
Key findings
01Dysphagia was confirmed in 28 of 149 patients, and silent aspiration was observed in 6 of those 28.
02Patients with dysphagia were older at diagnosis, had shorter disease duration, more underlying malignancy, higher mortality and more often received IVIg.
03Shorter disease duration and use of prednisolone or IVIg were independent predictors of dysphagia.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The study did not screen all patients routinely for swallowing problems; only 40 patients were assessed by speech therapists and 17 had instrumental assessment, so dysphagia may be underestimated. The multivariable analysis included only 28 patients with dysphagia and did not account for multiple comparisons, so the predictor findings may be overestimated. It was a single-centre retrospective chart review, so the sample may not represent other settings and records may have changed over time. Many patients identified from records were excluded because they lacked biopsy proof or complete information, which may affect who was studied. The association with prednisolone and IVIg may reflect more severe disease rather than a treatment effect.
The easy way to misread this
Do not conclude that prednisolone or IVIg caused dysphagia. The study found these treatments were independent predictors, but the authors note they may reflect more severe disease, and the retrospective design cannot show cause.