Effect of Dysphasia and Dysphagia on Inpatient Mortality and Hospital Length of Stay: A Database Study

Guyomard, Veronique; Fulcher, Robert; Redmayne, Oliver; Metcalf, Anthony K.; Potter, John F.; Myint, Phyo Kyaw

doi:10.1111/j.1532-5415.2009.02526.x

Cited by 133 publications

(108 citation statements)

References 23 publications

(32 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…We found that OD is a risk factor for mortality but discerned no difference in length of hospital stay. A recent study observed that in patients admitted for stroke, OD prolongs length of stay by almost 40% and is associated with 30.5% hospital mortality (vs. 2.8% in patients with non-OD) [28]. The difference between the results of that study and our own results might be related to the low prevalence of stroke patients in our care unit.…”

Section: Discussioncontrasting

confidence: 56%

Screening oropharyngeal dysphagia in hospitalized older adults: A prevalent problem associated with mortality

Tufan¹

2017

MMJ

View full text Add to dashboard Cite

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. Hastalar ve Yöntem:İstanbul'da bir üniversite hastanesi iç hastalıkları servisine başvuran 65 yaş üstü hastalar çalışmaya dahil edildi. Hastaların kullandığı ilaç sayısı, kronik hastalıkların sayısı, beslenme yolları (oral, parenteral veya her ikisi), hastanede kalış süresi, başvuru günündeki albümin düzeyleri ve çıkış mortalite durumu ilgili hekim tarafından kaydedildi. OD'yi taramak için EAT-10 anketi tüm hastalara uygulandı. Bulgular:Yüz otuz altı hasta (% 54,4 kadın) çalışmaya alındı. Yaş ortalaması 74,6 ± 6,6 yıl idi. Hastanede yatan yaşlı erişkinlerde OD prevalansı % 23 idi. Mortalite oranları disfajik olan hastalarda olmayanlara kıyasla anlamlı derecede yüksek bulundu (% 25,8 vs % 10,5; p=0.041). Malignite tanısı olan hastaların sayısı disfajik grupta anlamlı derecede yüksek bulundu (% 41,9 vs % 20; p=0.018).Sonuç: OD geriatrik bir sendromdur. Özellikle hastanede yatan tüm yaşlı hastalarda taranmalı ve tedavi edilmelidir. Bu yaklaşım hastaların durumunu ve yaşam kalitelerini arttıracaktır.

show abstract

Section: Discussioncontrasting

confidence: 56%

Screening oropharyngeal dysphagia in hospitalized older adults: A prevalent problem associated with mortality

Tufan¹

2017

MMJ

View full text Add to dashboard Cite

show abstract

“…2 Current rehabilitative strategies, including behavioral therapies have limited evidence base. 3 However, with recent developments in our understanding of the role of neuroplasticity and cortical reorganization in swallowing recovery, [4][5][6] there is now increasing interest that neurostimulation techniques can drive this natural recovery process.…”

Section: Introductionmentioning

confidence: 99%

“…[8][9][10][11][12] In contrast to behavioral swallowing treatments, PES appears to promote functional benefit through a central nonbiomechanical mechanism, such that dysphagia is improved regardless of physiological deficit. Furthermore, the optimal stimulation parameters (5-Hz frequency, 10 minutes duration, and 75% of maximum tolerated intensity) 8 have been shown to reverse the neurophysiological and behavioral effects of experimental brain 1 University of Manchester, Salford, UK 2 Salford Royal Foundation Trust, Salford, UK lesions, 9,13 and a dose-response study provided an optimal regimen in dysphagic stroke patients-once-daily stimulation for 3 days. 9 Moreover, in randomized clinical studies, PES improved swallowing within an hour poststimulation in both acute 8 and chronic 11 dysphagic stroke patients, as measured with videofluoroscopy (VFS).…”

Section: Introductionmentioning

confidence: 99%

Pharyngeal Electrical Stimulation in Dysphagia Poststroke

Vasant

Michou

O’Leary

et al. 2016

Neurorehabil Neural Repair

View full text Add to dashboard Cite

Background. Pharyngeal electrical stimulation (PES) appears to promote cortical plasticity and swallowing recovery poststroke. Objective. We aimed to assess clinical effectiveness with longer follow-up. Methods. Dysphagic patients (n = 36; median = 71 years; 61% male) recruited from 3 trial centers within 6 weeks of stroke, received active or sham PES in a single-blinded randomized design via an intraluminal pharyngeal catheter (10 minutes, for 3days). The primary outcome measure was the Dysphagia Severity Rating (DSR) scale (<4, no-mild; ≥4, moderate-severe). Secondary outcomes included unsafe swallows on the Penetration-Aspiration Scale (PAS ≥ 3), times to hospital discharge, and nasogastric tube (NGT) removal. Data were analyzed using logistic regression. Odds/hazard ratios (ORs/HRs) >1 for DSR <4, hospital discharge, and NGT removal and OR <1 for PAS ≥3, indicated favorable outcomes for active PES. Results. Two weeks post-active PES, 11/18 (61%) had DSR <4: OR (95% CI) = 2.5 (0.52, 14). Effects of active versus sham for secondary outcomes included the following: PAS ≥3 at 2 weeks, OR (95% CI) = 0.61 (0.27, 1.4); times to hospital discharge, 39 days versus 52 days, HR (95% CI) = 1.2 (0.55, 2.5); NGT removal 8 versus 14 days, HR (95% CI) = 2.0 (0.51, 7.9); and DSR <4 at 3 months, OR (95% CI) = 0.97 (0.13, 7.0). PES was well tolerated, without adverse effects or associations with serious complications (chest infections/death). Conclusions. Although the direction of observed differences were consistent with PES accelerating swallowing recovery over the first 2 weeks postintervention, suboptimal recruitment prevents definitive conclusions. Our study design experience and outcome data are essential to inform a definitive, multicenter randomized trial.

show abstract

“…1,2 Laboratory evidence of OPD can assist prevention of serious consequences in OPD patients. Several studies reported the utility of high-resolution impedance manometry (HRIM) for evaluation of oropharyngeal dysphagia.…”

Section: Introductionmentioning

confidence: 99%

Impedance Analysis Using High-resolution Impedance Manometry Facilitates Assessment of Pharyngeal Residue in Patients With Oropharyngeal Dysphagia

Lee¹,

Lee²,

Hong³

et al. 2014

J Neurogastroenterol Motil

View full text Add to dashboard Cite

Background/AimsImpedance analysis using high-resolution impedance manometry (HRIM) enables the recognition of pharyngeal residue in patients with oropharyngeal dysphagia. The aims of this study were to evaluate appropriate criteria for impedance analysis in a large patient cohort, as well as the diagnostic accuracy and agreement of analysis performed by HRIM trainees. MethodsWe reviewed 33 controls (13 males; median age, 61.2 years) and 104 oropharyngeal dysphagia patients (61 males; median age, 70.4 years) who underwent a flexible endoscopic evaluation of swallowing study (FEES) and HRIM. Two experts compared the pharyngeal residue on FEES and impedance color pattern at 1,000, 1,500 and 2,000 Ω of the impedance bar. Three trainees were given a 60 minutes tutorial to determine the diagnostic accuracy and agreement of this analysis. ResultsThe diagnostic sensitivity of experts for predicting liquid residue was 73.1% for 1,000 Ω, 96.2% for 1,500 Ω and 100% for 2,000 Ω. Significantly higher sensitivity was observed at 1,500 Ω compared to 1,000 Ω (P < 0.001). The diagnostic specificity of experts for liquid residue was 98.3% for 1,000 Ω, 96.6% for 1,500 Ω and 83.1% for 2,000 Ω. There was a higher specificity at 1,500 Ω compared to 2,000 Ω (P = 0.008). The κ value among the 3 trainees was 0.89 and the diagnostic accuracy of the trainees for liquid residue was comparable to that of the experts.

show abstract

Effect of Dysphasia and Dysphagia on Inpatient Mortality and Hospital Length of Stay: A Database Study

Cited by 133 publications

References 23 publications

Screening oropharyngeal dysphagia in hospitalized older adults: A prevalent problem associated with mortality

Screening oropharyngeal dysphagia in hospitalized older adults: A prevalent problem associated with mortality

Pharyngeal Electrical Stimulation in Dysphagia Poststroke

Impedance Analysis Using High-resolution Impedance Manometry Facilitates Assessment of Pharyngeal Residue in Patients With Oropharyngeal Dysphagia

Contact Info

Product

Resources

About