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与心血管疾病和 COVID-19 患者口咽吞咽困难相关的因素。

Factors associated with oropharyngeal dysphagia in individuals with cardiovascular disease and COVID-19.

机构信息

Instituto Dante Pazzanese de Cardiologia - São Paulo (SP), Brasil.

Universidade Estadual Paulista - UNESP - Marilia (SP), Brasil.

出版信息

Codas. 2024 Aug 19;36(5):e20220112. doi: 10.1590/2317-1782/20242022112en. eCollection 2024.

Abstract

PURPOSE

Oropharyngeal dysphagia (OD) is one of the possible outcomes in patients hospitalized with COVID-19 and also in the population hospitalized for the treatment of cardiovascular disease. Thus, knowing the predictive risk factors for OD may help with referral and early intervention. This study aimed to verify the association of different factors with OD in hospitalized individuals with cardiovascular disease and COVID-19.

METHODS

Cross-sectional clinical study approved by the Research Ethics Committee (4,521,771). Clinical evaluation of swallowing was carried out in 72 adult patients with cardiovascular disease and COVID-19 hospitalized from April to September 2020. Individuals under 18 years of age and without previous cardiovascular disease were excluded. The presence of general clinical and/or neurological complications, pronation, stay in the intensive care unit (ICU), orotracheal intubation (OTI), tracheostomy tube, oxygen support and age were considered as predictive risk factors for oropharyngeal dysphagia. Fisher's exact test, Mann Whitney test and logistic regression model were used for analysis.

RESULTS

General clinical complications (p=0.001), pronation (p=0.003), ICU stay (p=0.043), in addition to the need for oxygen supplementation (p=0.023) and age (p= 0 .037) were statistically significant factors associated. The pronation (0.013) and age (0.038) were independently associated with dysphagia. OTI (p=0.208), tracheostomy (p=0.707) and the presence of previous cerebrovascular accidents (p=0.493) were not statistically significant.

CONCLUSION

In this study, age and prone position were factors independently associated with oropharyngeal dysphagia, complications such as the need for oxygen supplementation, in addition to the need for ICU admission, were also associated factors in the population.

摘要

目的

口咽吞咽困难(OD)是 COVID-19 住院患者和心血管疾病住院患者的可能结果之一。因此,了解 OD 的预测性危险因素可能有助于转诊和早期干预。本研究旨在验证不同因素与心血管疾病和 COVID-19 住院患者 OD 的相关性。

方法

横断面临床研究,经研究伦理委员会批准(4,521,771)。对 2020 年 4 月至 9 月期间住院的 72 例心血管疾病合并 COVID-19 的成年患者进行吞咽临床评估。排除年龄在 18 岁以下和既往无心血管疾病的患者。一般临床和/或神经系统并发症、俯卧位、入住重症监护病房(ICU)、经口气管插管(OTI)、气管切开管、氧支持以及年龄被认为是口咽吞咽困难的预测性危险因素。采用 Fisher 确切检验、Mann-Whitney 检验和 logistic 回归模型进行分析。

结果

一般临床并发症(p=0.001)、俯卧位(p=0.003)、入住 ICU(p=0.043)、氧支持需求(p=0.023)和年龄(p=0.037)是统计学上显著相关的因素。俯卧位(0.013)和年龄(0.038)与吞咽困难独立相关。OTI(p=0.208)、气管切开术(p=0.707)和既往脑卒中(p=0.493)与吞咽困难无显著相关性。

结论

在这项研究中,年龄和俯卧位是与口咽吞咽困难独立相关的因素,需要氧支持、入住 ICU 等并发症也是该人群的相关因素。

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