Oropharyngeal dysphagia in older patients with hip fracture

Abstract

Background oropharyngeal dysphagia (OD) and hip fracture are common problems in older patients, both associated with important complications. Objective the aim of this study was to measure the prevalence and identify the main risk factors of dysphagia in older patients with hip fracture. Design a prospective study in an orthogeriatric unit of a university hospital over 10 months. Methods a total of 320 patients (mean age 86.2 years, 73.4% women) were assessed for dysphagia within 72 hours post-surgery using the Volume-Viscosity Swallow Test. Geriatric assessment, hip fracture management and complications were examined to determine their relationship with the presence of OD. Results dysphagia was present in 176 (55%) patients. Multivariate logistic regression analysis showed that the presence of delirium during hospitalization and the inability to perform instrumental activities of daily living before admission were associated with OD. Conclusions the prevalence of OD is high in hip fracture patients. Objective dysphagia assessment should be routinely included as part of the geriatric assessment of such patients.

Factores de riesgo de la disfagia en la tercera edad: una revisión bibliográfica de estudios observacionales

“…Una vez examinados los títulos y los resúmenes, se descartaron 85 estudios. Posteriormente, se evaluaron 47 estudios a texto completo, incluyéndose 13 de ellos en la presente revisión bibliográfica (Maeda et al, 2017;Pu et al, 2017;Streicher et al, 2018;Clayton et al, 2018;Lim et al, 2018;Saito et al, 2018;Byun et al, 2019;Cha et al, 2019;Tagliaferri et al, 2019;Xu et al, 2019;Chen et al, 2020;Mateos-Nozal et al, 2020, 2021. La Tabla 1 resume las características de las muestras, las variables de interés, las herramientas de evaluación, y los factores de riesgo de la disfagia de cada estudio.…”

“…Diseño de los estudios Con respecto al diseño metodológico de los estudios, 7 fueron estudios transversales (Pu et al, 2017;Lim et al, 2018;Streicher et al, 2018;Cha et al, 2019;Tagliaferri et al, 2019;Xu et al, 2019;Chen et al, 2020), 3 fueron estudios de casos y controles (Clayton et al, 2018;Saito et al, 2018;Byun et al, 2019) y 3 fueron estudios de cohortes (Maeda et al, 2017;Mateos-Nozal et al, 2020, 2021.…”

Short-Term Therapeutic Adherence of Hospitalized Older Patients with Oropharyngeal Dysphagia after an Education Intervention: Analysis of Compliance Rates, Risk Factors and Associated Complications

“…A single nurse was trained to perform V-VST, explain management, and collect data. Previous studies usually involved speech and language therapists in the diagnosis of OD [ 21 , 22 , 24 ], but nurses have shown to effectively diagnose OD [ 2 , 5 , 6 , 19 ]. Also, a current systematic review described that 49% of the articles include nurses among the participants, mainly in screening and performing a clinical assessment of OD [ 34 ].…”

“…Exclusion criteria: end-of life situations, permanent low level of consciousness that precluded performance of the V-VST, enteral nutrition administered by nasogastric tube or percutaneous endoscopic gastrostomy, and refusal to participate. The study population inclusion procedure has also been published elsewhere [ 2 , 19 ].…”

“…During hospital admission, a trained nurse collected demographic information, previous comorbidities and pharmacological treatment related to OD, geriatric assessment measures, the reason for hospitalization, presence of delirium during hospitalization, length of stay, and place of discharge, previously described in detail [ 2 , 19 ].…”