Ochoa Juan B
Nestlé HealthCare Nutrition, Nestlé Health Science, Florham Park, NJ, USA.
Nestle Nutr Inst Workshop Ser. 2012;72:77-83. doi: 10.1159/000339992. Epub 2012 Sep 24.
Dysphagia, a symptom characterized by difficulty swallowing, is an independent predictor of poor outcome, worsening morbidity, increasing the risk for hospital readmissions, health care costs and mortality. Dysphagia is a result of a number of illnesses including neurological diseases, after surgery for head and neck pathology, observed in the intensive care unit after prolonged endotracheal intubation among others, and is particularly frequent in the elderly. Dysphagia increases the incidence of malnutrition, which in turn delays patient recovery. Treatment of dysphagia can be successful, but requires the use of multidisciplinary teams. A focus on the management of malnutrition including prevention and treatment is essential. Perhaps the biggest challenge is the lack of awareness of the presence of dysphagia and malnutrition, so that only a minority of patients are identified and successfully treated. We propose that better identification and treatment of dysphagia could occur with the systematic implementation of clinical practice improvement processes with a consequent decrease in morbidity, mortality and cost.
吞咽困难是一种以吞咽困难为特征的症状，是不良预后、病情恶化、住院再入院风险增加、医疗保健成本和死亡率上升的独立预测因素。吞咽困难是多种疾病的结果，包括神经疾病、头颈部病变手术后、长时间气管插管后在重症监护病房观察到的情况等，在老年人中尤为常见。吞咽困难会增加营养不良的发生率，进而延迟患者康复。吞咽困难的治疗可能会成功，但需要多学科团队的参与。关注包括预防和治疗在内的营养不良管理至关重要。也许最大的挑战是对吞咽困难和营养不良存在情况的认识不足，以至于只有少数患者被识别并得到成功治疗。我们建议，通过系统实施临床实践改进流程，更好地识别和治疗吞咽困难，从而降低发病率、死亡率和成本。
