Department of Nursing, Kagoshima Medical Association Hospital, Kagoshima, Japan.
Department of Rehabilitation Medicine, Kumamoto Rehabilitation Hospital, 760 Magate, Kikuyo-Town, Kikuchi, Kumamoto, 869-1106, Japan.
Aging Clin Exp Res. 2020 Jun;32(6):1093-1099. doi: 10.1007/s40520-019-01287-3. Epub 2019 Jul 31.
Dysphagia is an important clinical problem in older adults with heart failure. Moreover, evidence is scarce regarding the prevalence and impact of dysphagia on physical function in these patients.
This study examined the association of dysphagia and physical function in patients undergoing cardiac rehabilitation following heart failure.
This prospective cohort study included consecutive 149 (mean age 78.6 years, 72 women) inpatients in an acute-care hospital. Outcomes included the Food Intake Level Scale (FILS) and Barthel Index (BI) as indicators of dysphagia status and physical function, respectively. Multivariate analyses were used to determine whether FILS scores on admission and at the point of heart failure stabilization were associated with BI at discharge.
Of the 149 patients, 14 (9.4%) had dysphagia at the time of stabilization of heart failure. Patients with dysphagia (FILS score < 7) were significantly older, more demented, exhibited lower muscle mass and strength, walked shorter distances, and had lower energy and protein intakes, longer length of stay, and lower BI scores (all, p < 0.05) compared to those without dysphagia. Multiple regression analyses showed that FILS score was independently associated with BI at discharge (β = 0.364, p < 0.001).
Dysphagia was associated with declined physical function in patients undergoing cardiac rehabilitation following heart failure. Early detection and management of dysphagia can promote timely functional recovery in these patients.
吞咽困难是老年心力衰竭患者的一个重要临床问题。此外,关于这些患者吞咽困难对身体功能的影响的证据很少。
本研究探讨了心力衰竭后接受心脏康复治疗的患者吞咽困难与身体功能的关系。
这项前瞻性队列研究纳入了一家急性护理医院的 149 例连续住院患者(平均年龄 78.6 岁,72 名女性)。结局包括食物摄入水平量表(FILS)和巴氏指数(BI),分别作为吞咽困难状况和身体功能的指标。采用多元分析来确定入院时和心力衰竭稳定时的 FILS 评分与出院时的 BI 是否相关。
在 149 例患者中,有 14 例(9.4%)在心力衰竭稳定时存在吞咽困难。有吞咽困难的患者(FILS 评分<7)年龄更大,更痴呆,肌肉量和力量更低,行走距离更短,能量和蛋白质摄入更少,住院时间更长,BI 评分更低(所有 p<0.05)。多元回归分析显示,FILS 评分与出院时的 BI 独立相关(β=0.364,p<0.001)。
吞咽困难与心力衰竭后接受心脏康复治疗的患者身体功能下降有关。早期发现和管理吞咽困难可以促进这些患者的及时功能恢复。