Altman Kenneth W, Yu Gou-Pei, Schaefer Steven D
Department of Otolaryngology, Mount Sinai School of Medicine, One Gustave L. Levy Place, Box 1189, New York, NY 10029, USA.
Arch Otolaryngol Head Neck Surg. 2010 Aug;136(8):784-9. doi: 10.1001/archoto.2010.129.
To determine if comorbid dysphagia in all hospitalized patients has the potential to prolong hospital stay and increase morbidity. Dysphagia is increasingly prevalent with age and comorbid medical conditions. Our research group has previously shown that dysphagia is a bad prognostic indicator in patients with stroke.
Analysis of national database.
The National Hospital Discharge Survey (NHDS), 2005-2006, was evaluated for presence of dysphagia and the most common comorbid medical conditions. Patient demographics, associated disease, length of hospital stay, morbidity and mortality were also evaluated.
There were over 77 million estimated hospital admissions in the period evaluated, of which 271,983 were associated with dysphagia. Dysphagia was most commonly associated with fluid or electrolyte disorder, esophageal disease, stroke, aspiration pneumonia, urinary tract infection, and congestive heart failure. The median number of hospitalization days for all patients with dysphagia was 4.04 compared with 2.40 days for those patients without dysphagia. Mortality increased substantially in patients with dysphagia associated with rehabilitation, intervertebral disk disorders, and heart diseases.
Dysphagia has a significant impact on hospital length of stay and is a bad prognostic indicator. Early recognition of dysphagia and intervention in the hospitalized patient is advised to reduce morbidity and length of hospital stay.
确定所有住院患者的合并吞咽困难是否有可能延长住院时间并增加发病率。吞咽困难随着年龄增长和合并症的出现而愈发普遍。我们的研究小组此前已表明，吞咽困难是中风患者的不良预后指标。
对国家数据库进行分析。
对2005 - 2006年国家医院出院调查（NHDS）中吞咽困难的存在情况以及最常见的合并症进行评估。还对患者人口统计学特征、相关疾病、住院时间、发病率和死亡率进行了评估。
在评估期间估计有超过7700万例住院病例，其中271,983例与吞咽困难有关。吞咽困难最常与液体或电解质紊乱、食管疾病、中风、吸入性肺炎、尿路感染和充血性心力衰竭相关。所有吞咽困难患者的住院天数中位数为4.04天，而无吞咽困难患者为2.40天。与康复、椎间盘疾病和心脏病相关的吞咽困难患者死亡率大幅增加。
吞咽困难对住院时间有显著影响，是不良预后指标。建议对住院患者尽早识别吞咽困难并进行干预，以降低发病率和缩短住院时间。
