Digestive Health

18 August 2010

Early Care Urged for Patients With Trouble Swallowing

'Dysphagia' significantly impacts hospital resources and patient outcomes, researchers say

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TUESDAY, Aug. 17 (HealthDay News) -- Difficulty swallowing (also called dysphagia) is associated with poor outcomes in hospital patients, researchers warn.

"The consequences of dysphagia can be profound. Although it is appreciated that nutrition, hydration, quality-of-life issues and social isolation may arise, aspiration (especially if not immediately recognized) may be the pivotal factor that precipitates a significant decline in a patient's outcome," wrote Dr. Kenneth W. Altman, of the Mount Sinai School of Medicine in New York City, and colleagues. An example of aspiration is when food gets into the airway.

In their study, the researchers analyzed data from nearly 272,000 dysphagia-related hospital admissions that were recorded in the 2005-2006 National Hospital Discharge Survey.

"Dysphagia was most commonly associated with fluid or electrolyte disorder, esophageal disease, stroke, aspiration pneumonia, urinary tract infection and congestive heart failure," the researchers wrote.

The investigators also found that being over 75 years of age was linked to a doubled risk of dysphagia.

The median number of days spent in the hospital was 40 percent longer for patients with dysphagia than for other patients -- 4.04 days versus 2.4 days. Among patients undergoing rehabilitation, the risk of death was 13 times higher for those with dysphagia, which also increased the risk of death among patients with intervertebral disk disorders and heart disease.

"While dysphagia occurs in only a small portion of hospitalized patients, the impact on hospital resources is substantial," the researchers concluded. "We recommend early identification of dysphagia in hospitalized patients, particularly in those with high-risk [coexisting] conditions such as older age, stroke, dehydration, malnutrition, neurodegenerative disease, pneumonia, cardiac disease and the need for rehabilitation. The plan of care in these patients should include proper assessment, early intervention using appropriate therapy and aspiration precautions, and consideration of [alternate] feeding or supplementation options in the high-risk populations."

The study findings are published in the August issue of the journal Archives of Otolaryngology -- Head & Neck Surgery.

More information

The U.S. National Institute on Deafness and Other Communication Disorders has more about dysphagia.


(Copyright © 2010 HealthDay. All rights reserved.)

 

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Dr. Estelle Wilken is a Senior Specialist in Internal Medicine and Gastroenterology at Tygerberg Hospital. She obtained her MBChB in 1976, her MMed (Int) in 1991 and her gastroenterology registration in 1995.

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