Bomze Laura, Dehom Salem, Lao Wilson P, Thompson Jordan, Lee Nathan, Cragoe Andrea, Luceno Cesar, Crawley Brianna
Department of Otolaryngology - Head and Neck Surgery, Loma Linda University Health, Loma Linda, California, U.S.A.
School of Nursing, Loma Linda University, Loma Linda, California, U.S.A.
Laryngoscope. 2021 Nov;131(11):2441-2447. doi: 10.1002/lary.29329. Epub 2021 Jan 25.
OBJECTIVE/HYPOTHESIS: Elderly individuals account for one-third of all hospitalizations. The goal of this study was to evaluate the prevalence of dysphagia in elderly patients admitted to a tertiary care center. It also sought to investigate how dysphagia is identified, how it covaries with malnutrition and other conditions, and how it impacts hospital stay.
Case Series.
A retrospective chart review was performed. All patients >65 years admitted to a tertiary care center in January and February 2016 were included. Patients with primary psychiatric diagnoses and patients with upper aerodigestive tract malignancy or surgery were excluded.
A total of 655 patients were identified. Mean age was 76.6 years. Twenty-four percent (155 patients) had dysphagia while 43% (282 patients) had malnutrition. Thirteen percent (84 patients) had both dysphagia and malnutrition. Fifty percent of patients who had malnutrition were seen by speech language pathology (SLP). One hundred percent of malnourished patients that saw SLP were identified as having dysphagia. Three hundred and eighty-two patients (58%) were seen by the dietician but not by SLP. Multiple logistic regression indicated that the presence of dysphagia was positively associated with age, presence of malnutrition, admission to either cardiology or neurology service as compared to medicine service, and history of stroke.
One-quarter of elderly patients admitted to our tertiary care center had dysphagia. Dysphagia, especially when linked with malnutrition, has poorer outcomes and increased healthcare costs. Our data suggests a possible disconnect between malnutrition diagnosis and dysphagia identification. This is an important area of intervention that has the potential to improve the treatment and outcomes of these patients.
4 Laryngoscope, 131:2441-2447, 2021.
目的/假设：老年患者占所有住院患者的三分之一。本研究的目的是评估三级医疗中心老年住院患者吞咽困难的患病率。该研究还试图调查吞咽困难是如何被识别的，它与营养不良和其他疾病如何共同变化，以及它如何影响住院时间。
病例系列研究。
进行回顾性病历审查。纳入2016年1月和2月入住三级医疗中心的所有65岁以上患者。排除原发性精神疾病诊断患者以及上消化道恶性肿瘤或手术患者。
共识别出655例患者。平均年龄为76.6岁。24%（155例患者）有吞咽困难，43%（282例患者）有营养不良。13%（84例患者）既有吞咽困难又有营养不良。50%有营养不良的患者接受了言语语言病理学（SLP）评估。接受SLP评估的营养不良患者中有100%被确定有吞咽困难。382例患者（58%）接受了营养师评估，但未接受SLP评估。多元逻辑回归表明，吞咽困难的存在与年龄、营养不良的存在、与内科相比入住心内科或神经内科、以及中风病史呈正相关。
入住我们三级医疗中心的老年患者中有四分之一有吞咽困难。吞咽困难，尤其是与营养不良相关时，预后较差且医疗费用增加。我们的数据表明营养不良诊断与吞咽困难识别之间可能存在脱节。这是一个重要的干预领域，有可能改善这些患者的治疗和预后。
4《喉镜》，131:2441 - 2447，2021年。
