Department of Surgery, Yale University School of Medicine, New Haven, CT, USA.
Gerontology. 2009;55(6):714-8. doi: 10.1159/000235824. Epub 2009 Aug 26.
To describe total and yearly demographic trends relative to aging, dysphagia referral rates and oral feeding status in hospitalized patients from 2000 through 2007.
We evaluated a prospective, consecutive, referred sample of 4,038 hospitalized patients in an urban, tertiary, acute care teaching hospital. Dysphagia referral rates are described according to year, age (decade), sex, admitting diagnostic category, results of dysphagia evaluations and oral feeding status. Diagnosis of dysphagia and feeding status were assessed objectively with fiberoptic endoscopic evaluation of swallowing.
Dysphagia referral rates doubled between 2000 and 2007, with increases of 20% per year and increases in all decades from 2002 through 2007. Over 70% of dysphagia referrals were for older patients of 60 years and above, and over 42% of these were old old patients over 80 years. Referrals for 80 to 89-year-old patients almost doubled and for patients over 90 years more than tripled between 2000 and 2007. Of older patients over 60 years, 62.3% (1,771/2,843) did not exhibit dysphagia, 18.0% (513/2,843) benefited from specific diet modifications to reduce aspiration risk and 19.7% (559/2,843) were made nil-by-mouth due to severe dysphagia and aspiration.
From 2000 to 2007, dysphagia referrals across all ages increased by 20% each year, with more referrals for older (70.4%) than younger patients (29.6%). Referrals almost doubled for 80 to 89-year-old patients and more than tripled for patients over 90 years. This increase will necessitate additional trained dysphagia specialists at least through 2050 and probably longer.
描述 2000 年至 2007 年期间与老龄化相关的住院患者总数和年度人口统计学趋势、吞咽困难转诊率和口服喂养状况。
我们评估了一家城市三级急性保健教学医院的 4038 例连续住院患者的前瞻性、连续、转诊样本。根据年份、年龄（十年）、性别、入院诊断类别、吞咽困难评估结果和口服喂养状况描述吞咽困难转诊率。通过纤维内镜吞咽评估客观评估吞咽困难和喂养状况的诊断。
2000 年至 2007 年间，吞咽困难转诊率翻了一番，每年增加 20%，2002 年至 2007 年间所有十年都有所增加。超过 70%的吞咽困难转诊是针对 60 岁及以上的老年患者，其中超过 42%是 80 岁以上的老老年患者。2000 年至 2007 年间，80 至 89 岁患者的转诊几乎翻了一番，90 岁以上患者的转诊增加了两倍多。在 60 岁以上的老年患者中，62.3%（1771/2843）没有表现出吞咽困难，18.0%（513/2843）通过特定的饮食调整受益于降低吸入风险，19.7%（559/2843）因严重吞咽困难和吸入而被禁食。
从 2000 年到 2007 年，所有年龄段的吞咽困难转诊率每年增加 20%，老年患者（70.4%）比年轻患者（29.6%）的转诊率更高。80 至 89 岁患者的转诊几乎翻了一番，90 岁以上患者的转诊增加了两倍多。这一增长将至少需要到 2050 年增加额外的经过培训的吞咽困难专家，而且可能需要更长时间。
