Risk scores for predicting dysphagia in critically ill patients after cardiac surgery

Abstract

BackgroundThis study aimed at developing and validating a scoring model to stratify critically ill patients after cardiac surgery based on risk for dysphagia, a common but often neglected complication.MethodsData were prospectively collected and analyzed from January 2016 to June 2017 from 395 consecutive post cardiac surgery patients at the cardiac care unit (CCU) at a single center; 103 (26.1%) developed dysphagia. Univariate and multivariate logistic analyses were used to identify independent predictors for dysphagia. The survival nomogram was developed on the basis of a multivariable Cox model, which allowed us to obtain survival probability estimations. The predictive performance of the nomogram was verified for discrimination and calibration. Areas under receiver operating characteristic curve analysis were used to illustrate and evaluate the diagnostic performance of the novel model.ResultsThe final novel scoring model, named SSG-OD, consists of three independent factors: gastric intubation (OR = 1.024, 95% CI 1.015–1.033), sedative drug use duration (OR = 1.031, 95% CI 1.001–1.063) and stroke or not (OR = 6.182, 95% CI 3.028–12.617). SSG-OD identified patients at risk for dysphagia with sensitivity of 68.5% and specificity of 89.0% (OR = 0.833, 95% CI: 0.782–0.884). The positive and negative likelihood ratios were 6.22 and 0.35.ConclusionsThe novel SSG-OD scoring system to risk stratify CCU patients for dysphagia is an easy-to-use bedside prognostication aid with good predictive performance and the potential to reduce aspiration incidence and accelerate recovery.

Factors Contributing to Post Extubation Dysphagia in Critically Ill Patients

“…This may related to gastric tube is a foreign object that traverses the path way of entire food through invasion of pharynx and esophagus till reached to stomach, that have direct effect on swallowing muscles especially when increase diameters and increase duration of it. This finding is in line with other studies (64,65) which found that the duration of gastric tube is one of the risk factors for certain prognosis value for predicting dysphagia.…”

Risk Score for Predicting Dysphagia in Patients After Neurosurgery: A Prospective Observational Trial

“…The existence of a nasogastric feeding tube can cause mechanical damage to the pharyngeal mucosa, laryngopharyngeal edema, sensory deficits, and swallowing-related muscle atrophy, which decreases swallowing function ( 24 ). Several studies have also reported the risk of feeding tube exposure ( 11 , 25 ). In addition, the long-term existence of the feeding tube can increase the risk of aspiration ( 26 , 27 ).…”

Development and validation of a nomogram to predict postoperative pulmonary complications following thoracoscopic surgery

“…When using the nomogram, only one variable should be positioned on the corresponding axis, and the points of all variables are summed to determine risk. Some scholars have carried out nomogram research in the field of anesthesia and achieved good results ( Ferrando et al., 2020 ; Ge et al, 2018 ; Hahn, 1995 ; Zhou et al, 2019 ).…”