Bhattacharyya Neil
Department of Otology & Laryngology, Harvard Medical School, Boston, Massachusetts, USA
Otolaryngol Head Neck Surg. 2014 Nov;151(5):765-9. doi: 10.1177/0194599814549156. Epub 2014 Sep 5.
To determine the prevalence of dysphagia, reported etiologies, and impact among adults in the United States.
Cross-sectional analysis of a national health care survey.
The 2012 National Health Interview Survey was analyzed, identifying adult cases reporting a swallowing problem in the preceding 12 months. In addition to demographic data, specific data regarding visits to health care professionals for swallowing problems, diagnoses given, and severity of the swallowing problem were analyzed. The relationship between swallowing problems and lost workdays was assessed.
An estimated 9.44 ± 0.33 million adults (raw N = 1554; mean age, 52.1 years; 60.2% ± 1.6% female) reported a swallowing problem (4.0% ± 0.1%). Overall, 22.7% ± 1.7% saw a health care professional for their swallowing problem, and 36.9% ± 0.1.7% were given a diagnosis. Women were more likely than men to report a swallowing problem (4.7% ± 0.2% versus 3.3% ± 0.2%, P < .001). Of the patients, 31.7% and 24.8% reported their swallowing problem to be a moderate or a big/very big problem, respectively. Stroke was the most commonly reported etiology (422,000 ± 77,000; 11.2% ± 1.9%), followed by other neurologic cause (269,000 ± 57,000; 7.2% ± 1.5%) and head and neck cancer (185,000 ± 40,000; 4.9% ± 1.1%). The mean number of days affected by the swallowing problem was 139 ± 7. Respondents with a swallowing problem reported 11.6 ± 2.0 lost workdays in the past year versus 3.4 ± 0.1 lost workdays for those without a swallowing problem (contrast, +8.1 lost workdays, P < .001).
Swallowing problems affect 1 in 25 adults, annually. A relative minority seek health care for their swallowing problem, even though the subjective impact and associated workdays lost with the swallowing problem are significant.
确定美国成年人吞咽困难的患病率、报告的病因及其影响。
对一项全国性医疗保健调查进行横断面分析。
分析了2012年全国健康访谈调查,确定了在过去12个月内报告有吞咽问题的成年病例。除人口统计学数据外,还分析了有关因吞咽问题就诊医疗保健专业人员、给出的诊断以及吞咽问题严重程度的具体数据。评估了吞咽问题与工作日损失之间的关系。
估计有944±33万成年人(原始样本量N = 1554;平均年龄52.1岁;女性占60.2%±1.6%)报告有吞咽问题(4.0%±0.1%)。总体而言,22.7%±1.7%的人因吞咽问题就诊于医疗保健专业人员,36.9%±1.7%的人得到了诊断。女性比男性更有可能报告有吞咽问题(4.7%±0.2%对3.3%±0.2%,P <.001)。在这些患者中,分别有31.7%和24.8%报告其吞咽问题为中度或重度/非常严重的问题。中风是最常报告的病因(42.2万±7.7万;11.2%±1.9%),其次是其他神经系统原因(26.9万±5.7万;7.2%±1.5%)和头颈癌(18.5万±4万;4.9%±1.1%)。受吞咽问题影响的平均天数为139±7天。有吞咽问题的受访者在过去一年报告有11.6±2.0个工作日损失,而没有吞咽问题的受访者为3.4±0.1个工作日损失(对比,多损失8.1个工作日,P <.001)。
吞咽问题每年影响二十五分之一的成年人。尽管吞咽问题的主观影响和相关的工作日损失很大,但相对少数人因吞咽问题寻求医疗保健。