Oral Motor Function Score feasibility and interrater reliability before extubation in intensive care patients

Post-extubation dysphagia (PED) is a frequent complication in critically ill patients. Fiberoptic endoscopic evaluation of swallowing (FEES) remains the diagnostic gold standard but is not feasible prior to extubation. The Oral Motor Function Score (OMFS) has been proposed as a simple bedside screening tool; however, data on its feasibility, inter-rater reliability, and preliminary predictive performance in general ICU populations are limited. We conducted a prospective observational pilot study of 50 consecutive ICU patients who fulfilled predefined clinical extubation-readiness criteria. An intensivist and an ICU nurse performed separate blinded OMFS assessments within 15 min before extubation. Primary outcome was interrater reliability. Secondary outcomes included item-level feasibility, RASS, post-extubation FEES findings, and exploratory clinical outcomes. Fifty patients were included in the final analysis. All five OMFS items were assessable in all patients. Median RASS was − 1, with a range from − 4 to + 1. Interrater reliability was high (Spearman r = 0.84; Krippendorff’s alpha = 0.84). OMFS showed a moderate positive correlation with the Murray Secretion Scale (rS = 0.49). Clinical adverse events were infrequent, limiting inferential analysis. In clinically extubation-ready ICU patients, OMFS showed high interrater reliability and complete item-level assessability. Its association with secretion management requires confirmation, and predictive value for clinical outcomes remains uncertain. Larger multicentre studies should standardize sedation, airway variables, and post-extubation FEES.