Department of Rehabilitation, Faculty of Allied Health Sciences, Yamato university, Osaka, Japan.
Department of Nursing, Nishinomiya Kyoritsu Neurosurgical Hospital, Hyogo, Japan.
Arch Gerontol Geriatr. 2024 Apr;119:105312. doi: 10.1016/j.archger.2023.105312. Epub 2023 Dec 12.
Oropharyngeal dysphagia is one of the most prevalent health complications in older adults. The prevalence of postoperative dysphagia is expected to rise with the increasing number of older patients undergoing orthopedic surgery; however, the specific prevalence and contributing factors remain unclear. This scoping review aimed to identify the prevalence and factors related to postoperative dysphagia in older orthopedic patients.
This review included studies published up to September 2022 on postoperative patients aged ≥ 60 years who underwent orthopedic surgery. We searched MEDLINE, EMBASE, CINAHL, CENTRAL, Web of Science, and Ichushi-Web.
In total, 21 of the 2158 identified studies were reviewed. The studies were classified into the three categories according to the surgical site: cervical spine disease (n = 12), hip fracture (n = 7), and others (n = 2). The estimated dysphagia prevalence rates [95 % confidence interval] of cervical spine disease, hip fractures, and others were 16 % [8-27], 32 % [15-54], and 6 % [4-8], respectively. Factors related to postoperative dysphagia included cervical alignment in cervical spine disease, being older within the cohort, preoperative health status, malnutrition, and sarcopenia in hip fractures.
The prevalence of postoperative dysphagia after orthopedic surgery was highest for hip fractures, followed by cervical spine and others. These results suggest non-neurogenic dysphagia in older patients undergoing orthopedic surgery and indicate that sarcopenia may contribute to postoperative dysphagia in this population. Therefore, further research should clarify the trajectory of postoperative dysphagia and the effectiveness of rehabilitation for postoperative dysphagia after orthopedic surgery.
口咽吞咽困难是老年人最常见的健康并发症之一。随着接受骨科手术的老年患者数量不断增加，预计术后吞咽困难的患病率将会上升；然而，具体的患病率和相关因素仍不清楚。本范围综述旨在确定老年骨科患者术后吞咽困难的患病率和相关因素。
本综述纳入了截至 2022 年 9 月发表的关于接受骨科手术、年龄≥60 岁的术后患者的研究。我们检索了 MEDLINE、EMBASE、CINAHL、CENTRAL、Web of Science 和 Ichushi-Web。
在总共 2158 项确定的研究中，有 21 项进行了综述。这些研究根据手术部位分为三类：颈椎疾病（n=12）、髋部骨折（n=7）和其他（n=2）。颈椎疾病、髋部骨折和其他的估计吞咽困难患病率（95%置信区间）分别为 16%[8-27]、32%[15-54]和 6%[4-8]。与术后吞咽困难相关的因素包括颈椎疾病中的颈椎排列、队列中年龄较大、术前健康状况、营养不良和髋部骨折中的肌肉减少症。
骨科手术后的术后吞咽困难患病率以髋部骨折最高，其次是颈椎疾病和其他。这些结果表明，骨科手术老年患者存在非神经性吞咽困难，并表明肌肉减少症可能导致该人群术后吞咽困难。因此，应进一步研究明确骨科手术后的术后吞咽困难轨迹以及术后吞咽困难康复的有效性。
