Identification of risk groups for oropharyngeal dysphagia in hospitalized patients in a university hospital (original) (raw)
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Profiling of Oropharyngeal Dysphagia in an Acute Care Hospital Setting
Ear, Nose & Throat Journal
Purpose: To identify the main complaints, diagnostic tools, as well as the treatment plan in patients presenting with oropharyngeal dysphagia in the acute care settings. Methods: The electronic medical chart of 100 consecutive hospitalized patients who presented an oropharyngeal dysphagia were retrospectively reviewed from January 2017 to January 2019. Results: The mean age of patients was 76.03 (standard deviation = 16.06) years old with 71% of patients being males. The most common admission diagnosis was pneumonia (30%), followed by stroke (28%). The swallowing evaluation was performed on the regular floor in 85% of patients and in the intensive care unit in 15% of patients. The main reasons for the swallowing evaluation are suspicion of aspiration by the medical or nursing teams (60%), systematic evaluation (20%), ear, nose and throat (ENT) complaints by the patient (14%), and aspiration pneumonia (6%). Fiberoptic endoscopic evaluation of swallowing with sensitivity testing was t...
Marmara Medical Journal
Objective: Oropharyngeal dysphagia (OD) is a common but underdiagnosed syndrome among older adults. The aim of this study was to assess the prevalence of OD in hospitalized older adults by using ten-item Eating Assessment Tool (EAT-10) and the relationship between mortality and OD. Patients and Methods: Patients aged over 65 years admitted to an internal medicine inpatient clinic of a university hospital in Turkey were enrolled in the study. The number of drugs, the number of chronic diseases, routes of feeding (oral, parenteral, or both), length of hospital stay, albumin levels on admission day, and mortality status of the patients were recorded by a physician. The EAT-10 questionnaire was administered to all patients for OD. Results: One hundred and thirty-six patients (54.4% female) were enrolled in the study. Their mean age was 74.6±6.6 years. The prevalence of OD in hospitalized older adults was 23%. The mortality rates were significantly higher in the dysphagic subjects as compared to the non-dysphagic ones (25.8% vs.10.5%; p=0.041). The number of patients with malignancy was significantly higher in the dysphagic group as compared to the non-OD subjects (41.9% vs.20%; p=0.018). Conclusion: OD is a geriatric syndrome and should be screened and treated in all geriatric patients in hospitals. It will improve patient outcomes and quality of life.
Stepping Stones to Living Well with Dysphagia, 2012
Oropharyngeal dysphagia describes difficulty with eating and drinking. This benign statement does not reflect the personal, social, and economic costs of the condition. Dysphagia has an insidious nature in that it cannot be 'seen' like a hemiplegia or a broken limb. It is often a comorbid condition, most notably of stroke, and many other neurodegenerative disorders. Conservative estimates of annual hospital costs associated with dysphagia run to USD 547 million. Length of stay rises by 1.64 days. The true prevalence of dysphagia is difficult to determine as it has been reported as a function of care setting, disease state and country of investigation. However, extrapolating from the literature, prevalence rises with admission to hospital and affects 55% of those in aged care settings. Consequences of dysphagia include malnutrition, dehydration, aspiration pneumonia and potentially death. The mean cost for an aspiration pneumonia episode of care is USD 17,000, rising with the number of comorbid conditions. Whilst financial costs can be objectively counted, the despair, depression, and social isolation are more difficult to quantify. Both sufferers and their families bear the social and psychological burden of dysphagia. There may be a cost-effective role for screening and early identification of dysphagia, particularly in high-risk populations.
Gastroenterology Research and Practice, 2011
Oropharyngeal dysphagia is a major complaint among older people. Dysphagia may cause two types of complications in these patients: (a) a decrease in the efficacy of deglutition leading to malnutrition and dehydration, (b) a decrease in deglutition safety, leading to tracheobronchial aspiration which results in aspiration pneumonia and can lead to death. Clinical screening methods should be used to identify older people with oropharyngeal dysphagia and to identify those patients who are at risk of aspiration. Videofluoroscopy (VFS) is the gold standard to study the oral and pharyngeal mechanisms of dysphagia in older patients. Up to 30% of older patients with dysphagia present aspiration-half of them without cough, and 45%, oropharyngeal residue; and 55% older patients with dysphagia are at risk of malnutrition. Treatment with dietetic changes in bolus volume and viscosity, as well as rehabilitation procedures can improve deglutition and prevent nutritional and respiratory complications in older patients. Diagnosis and management of oropharyngeal dysphagia need a multidisciplinary approach.
Dysphagia refers to any disturbance in movement of food bolus from mouth to stomach. Dysphagia may have many implications for social and physical health; dysphagic persons often have malnutrition and airway infections due to aspiration, and their reluctance to eat meals with others may lead to social isolation. Base on this fact that dysphagia can affect all health dimensions, knowledge of basic information about prevalence and etiology of dysphagia seems necessary. The purpose of this study was estimate the prevalence of dysphagia among patients, who were in Zahedan hospital wards. In this retrospective descriptive study, all of medical profiles of hospitalized patients of educational hospitals in the Zahedan city in the second Half of 2012 were selected. Data regarding existence or nonexistence of dysphagia, etiology of dysphagia, prevalence of dysphagia in different age and sex, and prevalence of dysphagia in different wards of the studied hospitals were recorded and for analysis SPSS 16 software was used. Among 7298 medical profiles of hospitalized patients, 2.1% of total patients had dysphagia and there wasn't significant difference between sexes regarding prevalence of dysphagia (P>0.05). The highest and lowest rates of dysphagia were observed for above 65 years old and between 0-19 years old, respectively. Also, the highest rates of dysphagia were in internal medicine ward. The results of present study suggest that speech therapist should be more aware to age and hospitals ward. With regard to higher prevalence of dysphagia in aging, and subsequent high risk of malnutrition and pneumonia, the more attention should be paid.
Screening of Oropharyngeal Dysphagia in Patients with Diabetes Mellitus
Biomedical Journal of Scientific & Technical Research
Background: Diabetes mellitus is a systemic endocrinal disease that results either from deficiency of insulin hormone (type 1) or from insulin resistance or both (type 2). Literature is scarce related to dysphagia with diabetes. This complaint is expressed by some patients and needs to be explored. A-EAT-10 is a questionnaire that explores the presence of dysphagia symptoms among patients. Aim: The aim of this work is to screen Egyptian diabetic patients (type 1 and type 2) in El-Demerdash hospital for oropharyngeal dysphagia using the validated Arabic version of Eating Assessment Tool (A-EAT-10) questionnaire to explore the degree of such symptom among them. Study design: This was a cross-sectional study conducted to screen the diabetic patients (of both type 1 and type 2) in El-Demerdash hospital for oropharyngeal dysphagia. Patients and methods: 200 Egyptian adult diabetic patients, aged 18y.1m.1d-59y.12m.31d, were included in this study. The participants were selected upon certain inclusion and exclusion criteria. The inclusion criteria were diabetic patients of type 1 and/or type 2. The exclusion criteria were any past or present history of disorders that might cause oropharyngeal dysphagia. Patients were asked to complete the Arabic version of the Eating Assessment Tool-10 (A-EAT-10) questionnaire. It is formed of 10 questions, and used to detect the presence of dysphagia complaints among patients and how it affects them. Results: The increase in age and having a female gender were considered of high risk for dysphagia among diabetic patients participating in this study. The commonest symptom among diabetic patients who complained from dysphagia was "I cough when I eat". There is no relation between the type or duration of diabetes mellitus and the presence of oropharyngeal dysphagia. Conclusion: The present study showed that diabetic patients may encounter swallowing problems. The A-EAT 10 is an easy method that can be used for screening of swallowing difficulty.
CoDAS, 2014
PURPOSE: To correlate the reason for referral to speech therapy service at a university hospital with the results of clinical and objective assessment of risk for dysphagia. METHODS: This is a cross-sectional, observational, retrospective analytical and quantitative study. The data were gathered from the database, and the information used was the reason for referral to speech therapy service, results of clinical assessment of the risk for dysphagia, and also from swallowing videofluoroscopy. RESULTS: There was a mean difference between the variables of the reason for the referral, results of the clinical and objective swallowing assessments, and scale of penetration/aspiration, although the values were not statistically significant. Statistically significant correlation was observed between clinical and objective assessments and the penetration scale, with the largest occurring between the results of objective assessment and penetration scale. CONCLUSION: There was a correlation bet...
Dysphagia
Medically unexplained oropharyngeal dysphagia (MUNOD) is a rare condition. It presents without demonstrable abnormalities in the anatomy of the upper aero-digestive tract and/or swallowing physiology. This study investigates whether MUNOD is related to affective or other psychiatric conditions. The study included patients with dysphagic complaints who had no detectible structural or physiological abnormalities upon swallowing examination. Patients with any underlying disease or disorder that could explain the oropharyngeal dysphagia were excluded. All patients underwent a standardized examination protocol, with FEES examination, the Hospital Anxiety and Depression Scale (HADS), and the Dysphagia Severity Scale (DSS). Two blinded judges scored five different FEES variables. None of the 14 patients included in this study showed any structural or physiological abnormalities during FEES examination. However, the majority did show abnormal piecemeal deglutition, which could be a symptom of MUNOD. Six patients (42.8%) had clinically relevant symptoms of anxiety and/or depression. The DSS scores did not differ significantly between patients with and without affective symptoms. Affective symptoms are common in patients with MUNOD, and their psychiatric conditions could possibly be related to their swallowing problems.
Risk factors for oropharyngeal dysphagia in cardiovascular diseases
Journal of Applied Oral Science, 2020
Risk factors for oropharyngeal dysphagia in cardiovascular diseases Some conditions consolidated as risk factors for oropharyngeal dysphagia have already been identified in other diseases, such as neurological. Studies on cardiovascular diseases concentrate in individuals in the postoperative period; thus, it is unknown if these same factors occur in individuals hospitalized for clinical or surgical treatment of these diseases. Objective: to correlate predictive risk factors for oropharyngeal dysphagia in individuals with cardiovascular disease admitted at a reference cardiology hospital. Methodology: This is a retrospective clinical study. Medical records of 175 individuals hospitalized for clinical and/or surgical treatment at a reference cardiology hospital from January to June 2017, attendants of the Speech-Language Pathology and Nutrition team, were analyzed. Of these, 100 records were included in the study: 41 females and 59 males (mean age 67.56 years). Deaths and individuals from 0 to 18 years were excluded. Stroke, malnutrition, age and prolonged orotracheal intubation were considered predictive risk factors for oropharyngeal dysphagia. Mann-Whitney test and Fisher's test were used for statistical analysis. Results: Stroke (OR=2.93 p=0.02), malnutrition (OR=2.89 p=0.02) and prolonged orotracheal intubation (OR=3.94 p=0.02) were statistically significant predictors for oropharyngeal dysphagia within this population. Age below 80 years was not significant (p=0.06), but within octogenarians, significance was found (p=0.033). Conclusion: Stroke, malnutrition, prolonged orotracheal intubation and age > 80 years are predictive risk factors for oropharyngeal dysphagia in adult population with cardiovascular diseases.