Galán Sánchez-Heredero María José, Santander Vaquero Cecilio, Cortázar Sáez Milagros, de la Morena López Felipe, Susi García Rosario, Martínez Rincón María Del Carmen
Unidad de Aparato Digestivo y Urología, Hospital Universitario de La Princesa, Madrid, España.
Unidad de Aparato Digestivo, Hospital Universitario de La Princesa, Madrid, España.
Enferm Clin. 2014 May-Jun;24(3):183-90. doi: 10.1016/j.enfcli.2013.12.009. Epub 2014 Feb 21.
The main objective of this study was to understand the relationship between oropharyngeal dysphagia, nutritional risk factors and functional impairment in the elderly (>65y) admitted to a medical-surgical hospital unit. Secondary objectives were to determine the prevalence of oropharyngeal dysphagia, the nutritional status and their functional capacity.
A cross-sectional observational study was performed. It included patients over 65 years of age admitted to the Gastroenterology-Urology Department in La Princesa University Hospital (Madrid, Spain) during the months of February and March. The following variables were recorded: age, sex, body mass index, family support, diagnosis, comorbidity, oropharyngeal dysphagia (EAT-10 and volume-viscosity evaluation method), malnutrition (Mininutritional Assessment) and functional capacity (Barthel index).
A total of 167 patients were recruited, with 30.8% and 15.4% prevalence of dysphagia and malnutrition, respectively. Prevalence of malnutrition increased to 75% in patients with oropharyngeal dysphagia. The logistic regression analysis showed how conditions as low score on the Barthel index (OR 0.97 [95% CI, 0.95-0.99]), comorbidity (OR 7.98 [CI 95%, 3.09-20.61]) and dysphagia (OR 4.07 [CI 95%, 1.57-10.52]) were associated with a greater likelihood of suffering malnutrition.
Oropharyngeal dysphagia is one of the most underdiagnosed and underestimated conditions among elderly patients and one that has a greater effect on their nutritional status. Accordingly, we suggest using established diagnostic methods with a multidisciplinary team collaboration for its early detection.
本研究的主要目的是了解入住内科-外科病房的老年患者（>65岁）的口咽吞咽困难、营养风险因素与功能障碍之间的关系。次要目的是确定口咽吞咽困难的患病率、营养状况及其功能能力。
进行了一项横断面观察性研究。研究对象包括2月和3月期间入住西班牙马德里拉普林塞萨大学医院胃肠病学-泌尿学科室的65岁以上患者。记录了以下变量：年龄、性别、体重指数、家庭支持、诊断、合并症、口咽吞咽困难（采用EAT-10和容量-粘度评估方法）、营养不良（采用微型营养评定法）和功能能力（巴氏指数）。
共招募了167名患者，吞咽困难和营养不良的患病率分别为30.8%和15.4%。口咽吞咽困难患者的营养不良患病率增至75%。逻辑回归分析显示，巴氏指数得分低（比值比0.97[95%置信区间，0.95-0.99]）、合并症（比值比7.98[95%置信区间，3.09-20.61]）和吞咽困难（比值比4.07[95%置信区间，1.57-10.52]）与营养不良的可能性更大相关。
口咽吞咽困难是老年患者中诊断不足和重视不够的疾病之一，对其营养状况有较大影响。因此，我们建议采用既定的诊断方法并通过多学科团队协作进行早期检测。
