Bosch Guillermo, Comas Mercè, Domingo Laia, Guillen-Sola Anna, Duarte Esther, Castells Xavier, Sala Maria
Department of Epidemiology and Evaluation, Parc de Salut MAR (PSMAR), Barcelona, Spain.
Preventive Medicine and Public Health Training Unit PSMar-UPF-ASPB (Parc de Salut Mar - Pompeu Fabra University - Agència de Salut Pública de Barcelona), Barcelona, Spain.
Eur J Clin Invest. 2023 Apr;53(4):e13930. doi: 10.1111/eci.13930. Epub 2022 Dec 16.
Oropharyngeal dysphagia can be highly concerning in hospitalized patients, increasing morbidity and mortality, making its early identification essential. We aimed to characterize dysphagia and its association with aspiration pneumonia and mortality in a tertiary hospital in Barcelona, Spain.
Using data from all hospital discharges during the period 2018-2021, we identified the characteristics of patients with dysphagia and their distribution among hospital departments through the minimum data set, which codifies patients' diagnoses according to the International Classification of Diseases 10th Revision (ICD-10). We used logistic regression models to assess the association between dysphagia, aspiration pneumonia and mortality.
Dysphagia was present in 2.4% of all hospital discharges and was more frequent in older patients and in men. The diagnoses most frequently associated with dysphagia were aspiration pneumonia (48.2%) and stroke (14%). Higher prevalence of dysphagia was found in the acute geriatric unit (10.3%), neurology (7.6%) and internal medicine (7.5%) wards. Dysphagia was associated with aspiration pneumonia, aOR = 8.04 (95%CI, 6.31-10.25), and independently increased the odds of death among hospitalized patients, aOR = 1.43 (95%CI, 1.19-1.73).
We conclude that dysphagia is a prevalent and transversal condition, increasing the risk of mortality in all patients, and efforts should be intensified to increase its early detection and correct management.
口咽吞咽困难在住院患者中可能引起高度关注,会增加发病率和死亡率,因此早期识别至关重要。我们旨在描述西班牙巴塞罗那一家三级医院中吞咽困难的特征及其与吸入性肺炎和死亡率的关联。
利用2018 - 2021年期间所有医院出院患者的数据,我们通过最小数据集确定了吞咽困难患者的特征及其在医院各科室的分布情况,该数据集根据国际疾病分类第10版(ICD - 10)对患者诊断进行编码。我们使用逻辑回归模型评估吞咽困难、吸入性肺炎和死亡率之间的关联。
所有出院患者中2.4%存在吞咽困难,在老年患者和男性中更为常见。与吞咽困难最常相关的诊断是吸入性肺炎(48.2%)和中风(14%)。在急性老年病科(10.3%)、神经科(7.6%)和内科(7.5%)病房发现吞咽困难的患病率较高。吞咽困难与吸入性肺炎相关,调整后比值比(aOR)= 8.04(95%置信区间,6.31 - 10.25),并且独立增加了住院患者死亡的几率,aOR = 1.43(95%置信区间,1.19 - 1.73)。
我们得出结论,吞咽困难是一种普遍且贯穿各科室的情况,增加了所有患者的死亡风险,应加大力度提高其早期检测和正确管理。