Silveira Guijarro L J, Domingo García V, Montero Fernández N, Osuna del Pozo C Ma, Álvarez Nebreda L, Serra-Rexach J A
Servicio de Geriatría, Hospital General Universitario Gregorio Marañón, Madrid, España.
Nutr Hosp. 2011 May-Jun;26(3):501-10. doi: 10.1590/S0212-16112011000300011.
To describe the prevalence of oropharyngeal dysphagia at hospital discharge in elderly patients admitted to a Subacute Care Unit (SACU) using the Volume-Viscosity Swalow Test (V-VST) and an adapted version for severe dementia (V-VST-G). METHODOLOGY AND DESIGN: Descriptive cross-sectional study; duration; 50 days. Data gathered from the clinical chart at hospital discharge: demographical, clinical, risk factors, and complications of dysphagia, functional course, and V-VCAM and V-VCAM-G outcomes. The results are described comparing the data of the groups with and without dysphagia.
86 Patients (60% women), mean age 83.8 ± 6.7 years. The specific clinical history detected previous oropharyngeal dysphagia in 23 patients (26%). The V-VCAM detected oropharyngeal dysphagia in 46 patients (53.5%). Of them, 30 patients (65.21%) had mixed swallowing disorder, 15 (32.6%) had isolated efficacy disorder, and 1 (2.17%) had isolated safety disorder. Those patients with a positive dysphagia test had a statistically significant higher prevalence of cognitive disorder, higher age, and more positive history of previous dysphagia, worse functional course and mobility impairment, and more complications during their staying at the SACU.
Dysphagia is highly prevalent among this group of elderly patients. Only half of the cases are diagnosed through the specific anamnesis. The V-VCAM detected a high prevalence of dysphagia so that its routine use is recommended specially in patients at risk taking into account the peculiarities of using it in the elderly. This at-risk population would be defined by characteristics such as higher age, cognitive and/or functional impairment.
使用容量 - 黏度吞咽测试（V - VST）及针对重度痴呆的改编版（V - VST - G），描述入住亚急性护理单元（SACU）的老年患者出院时口咽吞咽困难的患病率。
描述性横断面研究；持续时间：50天。从出院时的临床病历中收集数据：人口统计学、临床、吞咽困难的危险因素和并发症、功能进程以及V - VCAM和V - VCAM - G结果。通过比较有吞咽困难和无吞咽困难两组的数据来描述结果。
86例患者（60%为女性），平均年龄83.8±6.7岁。特定临床病史显示23例患者（26%）既往有口咽吞咽困难。V - VCAM检测出46例患者（53.5%）存在口咽吞咽困难。其中，30例患者（65.21%）有混合性吞咽障碍，15例（32.6%）有单纯有效性障碍，1例（2.17%）有单纯安全性障碍。吞咽困难测试呈阳性的患者在认知障碍患病率、年龄较大、既往吞咽困难病史阳性率、功能进程较差和活动能力受损方面以及在SACU住院期间出现更多并发症方面具有统计学显著差异。
吞咽困难在这组老年患者中非常普遍。只有一半的病例通过特定问诊得以诊断。V - VCAM检测出吞咽困难的患病率很高，因此建议常规使用，尤其要考虑到在老年人中使用的特殊性，对有风险的患者特别推荐使用。这类有风险的人群可由年龄较大、认知和/或功能受损等特征来界定。
