{
  "abstract": "Introduction SSc is characterized by fibrosis of various organs including the gastrointestinal (GI) tract. Traditionally, swallowing disorders in SSc have been attributed to microaspiration due to esophageal dysphagia. However, recent studies have reported that pharyngeal dysphagia was also involved in aspiration. EAT-10 is used as a screening questionnaire for swallowing disorders. It can assess aspiration and dysphagia of the esophagus and pharynx. Although there are many studies on esophageal dysphagia in SSc, and patient reported outcomes (PROs) have also been examined, there is still no evidence regarding screening for aspiration in SSc. Our aim was to evaluate the usefulness of PROs for detecting aspiration in patients with SSc.Material and Methods Patients with SSc who visited our department between 2021 and 2024 were included and underwent both PRO assessments and videofluoroscopic (VF) swallowing study. Patients with SSc fulfilled the 2013 ACR/EULAR classification criteria. EAT-10 was used as a PRO for evaluating swallowing and swallowing at risk of aspiration was defined as ‘unsafe swallowing (US)’ on VF swallowing study when the Penetration-Aspiration Scale was 3 or more. The reflux scores of UCLA GIT-2.0 and Frequency Scale for the Symptoms of GERD (FSSG) were used as PROs for gastroesophageal reflux disease (GERD). The diagnostic performance of EAT-10 for detecting US was analyzed using ROC curves. The association among PRO, US, and clinical features was evaluated.Results Fifty-four patients were included. The mean age was 64 ± 13 years, 76% were female, and 35% had diffuse cutaneous SSc. The mean total EAT-10 score was 3.5 ± 4.8. 28 (52%) had an EAT-10 score of 2 or more. US was detected in 15 patients (29%) by VF swallowing study. Higher EAT-10 scores were associated with US, and ROC analysis demonstrated the highest AUC at a cutoff of 2 or more (p = 0.034, AUC = 0.69, sensitivity 73%, specificity 64%). The cutoff value of 2 or more was also associated with physical frailty, the use of PPIs and/or PCABs, FSSG, bloating scores, constipation scores, social functioning scores, emotional well-being scores, and total scores of UCLA GIT-2.0. US was associated with constipation and fecal soilage scores of UCLA GIT-2.0, HAQ-DI, physical frailty, nailfold capillary abnormalities, and ESR, but not associated with reflux scores of UCLA GIT-2.0 and FSSG.Conclusions Almost half of patients had EAT-10 score 2 or more, which was associated with swallowing at risk of aspiration. EAT-10 might be useful PRO for screening aspiration in SSc.",
  "authors": [
    {
      "affiliations": [
        "Fujita Health University School of Medicine, Division of Rheumatology, Department of Internal Medicine, Toyoake, Japan"
      ],
      "name": "Tatsuaki Naganawa"
    },
    {
      "affiliations": [
        "Fujita Health University of Health Science, Faculty of Rehabilitation, Toyoake, Japan"
      ],
      "name": "Ayako Kuwabara"
    },
    {
      "affiliations": [
        "Fujita Health University School of Medicine, Division of Rheumatology, Department of Internal Medicine, Toyoake, Japan"
      ],
      "name": "Risa Ohara"
    },
    {
      "affiliations": [
        "Fujita Health University School of Medicine, Division of Rheumatology, Department of Internal Medicine, Toyoake, Japan"
      ],
      "name": "Naoki Dosoden"
    },
    {
      "affiliations": [
        "Fujita Health University School of Medicine, Division of Rheumatology, Department of Internal Medicine, Toyoake, Japan"
      ],
      "name": "Kodai Ito"
    },
    {
      "affiliations": [
        "Fujita Health University School of Medicine, Division of Rheumatology, Department of Internal Medicine, Toyoake, Japan"
      ],
      "name": "Marika Sawada"
    },
    {
      "affiliations": [
        "Fujita Health University School of Medicine, Division of Rheumatology, Department of Internal Medicine, Toyoake, Japan"
      ],
      "name": "Natsuko Watanabe"
    },
    {
      "affiliations": [
        "Fujita Health University School of Medicine, Division of Rheumatology, Department of Internal Medicine, Toyoake, Japan"
      ],
      "name": "Yumi Ito"
    },
    {
      "affiliations": [
        "Fujita Health University School of Medicine, Division of Rheumatology, Department of Internal Medicine, Toyoake, Japan"
      ],
      "name": "Ai Umeda"
    },
    {
      "affiliations": [
        "Fujita Health University School of Medicine, Division of Rheumatology, Department of Internal Medicine, Toyoake, Japan"
      ],
      "name": "Konomi Akamatsu"
    },
    {
      "affiliations": [
        "Fujita Health University School of Medicine, Division of Rheumatology, Department of Internal Medicine, Toyoake, Japan"
      ],
      "name": "Megumi Kurumizawa"
    },
    {
      "affiliations": [
        "Fujita Health University School of Medicine, Division of Rheumatology, Department of Internal Medicine, Toyoake, Japan"
      ],
      "name": "Takako Hashimoto"
    },
    {
      "affiliations": [
        "Fujita Health University School of Medicine, Division of Rheumatology, Department of Internal Medicine, Toyoake, Japan"
      ],
      "name": "Shusaku Fukaya"
    },
    {
      "affiliations": [
        "Fujita Health University School of Medicine, Department of Rehabilitation Medicine, Toyoake, Japan"
      ],
      "name": "Seiko Shibata"
    },
    {
      "affiliations": [
        "Fujita Health University School of Medicine, Department of Rehabilitation Medicine, Toyoake, Japan"
      ],
      "name": "Yohei Otaka"
    },
    {
      "affiliations": [
        "Fujita Health University School of Medicine, Division of Rheumatology, Department of Internal Medicine, Toyoake, Japan"
      ],
      "name": "Hidekata Yasuoka"
    }
  ],
  "title": "P.169 The usefulness of eating assessment Tool-10 (EAT-10) in patients with systemic sclerosis (SSc) for detecting swallowing at risk of aspiration",
  "uid": "87af66aa-af1d-58bd-8b70-5ecdb20c6fcd"
}