Relationship Between Oral Frailty Index‐8 Cutoff Values and Dysphagia in Older Patients With Hip Fracture: A Retrospective Cohort Study

ABSTRACT Background Early detection of dysphagia, which is frequent in older patients with hip fractures, is challenging. Oral frailty, reflecting age‐related decline in oral function, may serve as an early indicator of dysphagia risk. Objectives To evaluate whether preoperative oral frailty, assessed by the Oral Frailty Index‐8 (OFI‐8), is associated with dysphagia and to determine the optimal OFI‐8 cutoff for predicting it. Methods This single‐centre retrospective cohort study included 130 patients ≥ 65 years with hip fractures. Preoperative oral frailty was assessed using OFI‐8. Dysphagia at discharge was defined as a Functional Oral Intake Scale score ≤ 5. Logistic regression analysis with Firth's penalised likelihood method was performed to evaluate associations between dysphagia risk and both oral frailty status (present/absent) and OFI‐8 scores. Receiver operating characteristic (ROC) analysis was conducted to determine the optimal OFI‐8 cutoff. Results Dysphagia was observed in 10.0% (13/130) of the patients. None of the patients without oral frailty developed dysphagia, whereas 13.8% of those with oral frailty did ( p = 0.019). Higher OFI‐8 scores were significantly associated with increased dysphagia risk (odds ratio = 1.81; 95% confidence interval [CI]: 1.27–2.98; p < 0.001). ROC analysis identified an OFI‐8 cutoff of 7, with an area under the curve of 0.886, sensitivity 92.3%, and specificity 72.6%. Severe oral frailty (OFI‐8 ≥ 7) was strongly associated with dysphagia (odds ratio = 13.35; 95% CI: 2.80–130.87; p < 0.001). Conclusion Higher OFI‐8 scores and severe oral frailty are independently associated with dysphagia risk.