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老年髋部骨折患者的口咽性吞咽困难。

Oropharyngeal dysphagia in older patients with hip fracture.

机构信息

Servicio de Geriatría, Hospital Universitario Ramón y Cajal (IRYCIS), Madrid, Spain.

出版信息

Age Ageing. 2021 Jun 28;50(4):1416-1421. doi: 10.1093/ageing/afab032.

Abstract

BACKGROUND

oropharyngeal dysphagia (OD) and hip fracture are common problems in older patients, both associated with important complications.

OBJECTIVE

the aim of this study was to measure the prevalence and identify the main risk factors of dysphagia in older patients with hip fracture.

DESIGN

a prospective study in an orthogeriatric unit of a university hospital over 10 months.

METHODS

a total of 320 patients (mean age 86.2 years, 73.4% women) were assessed for dysphagia within 72 hours post-surgery using the Volume-Viscosity Swallow Test. Geriatric assessment, hip fracture management and complications were examined to determine their relationship with the presence of OD.

RESULTS

dysphagia was present in 176 (55%) patients. Multivariate logistic regression analysis showed that the presence of delirium during hospitalization and the inability to perform instrumental activities of daily living before admission were associated with OD.

CONCLUSIONS

the prevalence of OD is high in hip fracture patients. Objective dysphagia assessment should be routinely included as part of the geriatric assessment of such patients.

摘要

背景

口咽吞咽困难(OD)和髋部骨折是老年患者常见的问题,两者都与重要的并发症有关。

目的

本研究旨在测量老年髋部骨折患者吞咽困难的患病率,并确定其主要危险因素。

设计

这是一项在 10 个月内对大学医院骨科老年病房进行的前瞻性研究。

方法

在术后 72 小时内,通过容积粘度吞咽测试对 320 名(平均年龄 86.2 岁,73.4%为女性)患者进行吞咽困难评估。对老年综合评估、髋部骨折管理和并发症进行检查,以确定它们与 OD 存在的关系。

结果

176 名(55%)患者存在吞咽困难。多变量逻辑回归分析显示,住院期间出现谵妄和入院前无法进行工具性日常生活活动与 OD 有关。

结论

髋部骨折患者的 OD 患病率较高。应常规将客观吞咽评估作为此类患者老年综合评估的一部分。

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