Sex and BMI as predictors of pill residue in dysphagia: a multivariate analysis

We aimed to explore the specific challenges encountered by individuals with dysphagia when taking oral medications, focusing on the types of dysphagia that impede pill swallowing and the relationship between body mass index (BMI) and pill residue. We retrospectively reviewed 70 patients who underwent videofluoroscopic swallowing studies at the Department of Dysphagia Rehabilitation, Tokyo Medical and Dental University Dental Hospital between May 2013 and March 2020. Patients were assessed for pill residue in various anatomical locations, including the mouth, epiglottic vallecula, and piriform sinus. Patient demographics, BMI, functional oral intake scale scores, and clinical histories were collected. Pill residue was most commonly observed in the epiglottic vallecula (17% of patients), followed by the piriform sinus (10%) and mouth (9%). Males were more likely to have tablet residue in the epiglottic vallecula (p = 0.047), and a lower BMI was associated with increased pill residue in the piriform sinus (p = 0.025). Multivariate analysis identified sex as a significant predictor of epiglottic pill residue (p = 0.031), whereas a lower BMI was associated with pill residue in the piriform sinus (p = 0.016). Sex and BMI significantly influenced pill residue in patients with dysphagia; males and individuals with a lower BMI (< 18.5 kg/m2) were at higher risk.