Screening oropharyngeal dysphagia in hospitalized older adults: A prevalent problem associated with mortality

Aslı TUFAN
322 117

Öz


Objective: Oropharyngeal dysphagia (OD) is a common but
underdiagnosed syndrome among older adults. The aim of this
study was to assess the prevalence of OD in hospitalized older
adults by using ten-item Eating Assessment Tool (EAT-10) and the
relationship between mortality and OD.
Patients and Methods: Patients aged over 65 years admitted
to an internal medicine inpatient clinic of a university hospital
in Turkey were enrolled in the study. The number of drugs, the
number of chronic diseases, routes of feeding (oral, parenteral,
or both), length of hospital stay, albumin levels on admission day,
and mortality status of the patients were recorded by a physician.
The EAT-10 questionnaire was administered to all patients for OD.
Results: One hundred and thirty-six patients (54.4% female)
were enrolled in the study. Their mean age was 74.6±6.6 years.
The prevalence of OD in hospitalized older adults was 23%. The
mortality rates were significantly higher in the dysphagic subjects
as compared to the non-dysphagic ones (25.8% vs.10.5%; p=0.041).
The number of patients with malignancy was significantly higher
in the dysphagic group as compared to the non-OD subjects (41.9%
vs.20%; p=0.018).
Conclusion: OD is a geriatric syndrome and should be
screened and treated in all geriatric patients in hospitals. It will
improve patient outcomes and quality of life.
Keywords: Hospitalization, Older patients, Oropharyngeal
dysphagia, Screening, Mortality


Tam metin:

PDF (English)


DOI: http://dx.doi.org/10.5472/MMJoa.2016.2903.03

Referanslar


Rofes L, Arreola V, Romea M, et al. Pathophysiology

of oropharyngeal dysphagia in the frail elderly.

Neurogastroenterol Motil 2010;22:851-8, e230. doi:

1111/j.1365-2982.2010.01521.x.

Serra-Prat M, Hinojosa G, Lopez D, et al. Prevalence of

oropharyngeal dysphagia and impaired safety and efficacy of

swallow in independently living older persons. J Am Geriatr

Soc 2011 ;59:186-7.doi: 10.1111/j.1532-5415.2010.03227.x.

Lin LC, Wu SC, Chen HS, Wang TG, Chen MY. Prevalence

of impaired swallowing in institutionalized older people

in taiwan. J Am Geriatr Soc 2002;50:1118-23. doi

1046/j.1532-5415.2002.50270.x

Issa Okubo Pde C, Dantas RO, Troncon LE, Moriguti

JC, Ferriolli E. Clinical and scintigraphic assessment of

swallowing of older patients admitted to a tertiary care

geriatric ward. Dysphagia 2008;23:1-6. doi: 10.1007/

s00455-007-9087-2

Cabre M, Serra-Prat M, Palomera E, Almirall J, Pallares R,

Clave P. Prevalence and prognostic implications of dysphagia

in elderly patients with pneumonia. Age Ageing 2010;39:39-

doi: 10.1093/ageing/afp100

Carrion S, Cabre M, Monteis R, et al. Oropharyngeal

dysphagia is a prevalent risk factor for malnutrition in a

cohort of older patients admitted with an acute disease to a

general hospital. Clin Nutr 2015;34:436-42. doi: 10.1016/j.

clnu.2014.04.014

Wakabayashi H, Matsushima M. Dysphagia Assessed by the

-Item Eating Assessment Tool is associated with nutritional

status and activities of daily living in elderly individuals

requiring long-term care. J Nutr Health Aging 2016;20:22-7.

doi: 10.1007/s12603-015-0481-4

Cabre M, Serra-Prat M, Force L, Almirall J, Palomera

E, Clave P. Oropharyngeal dysphagia is a risk factor for

readmission for pneumonia in the very elderly persons:

observational prospective study. J Gerontol A Biol Sci Med

Sci 2014;69:330-7. doi: 10.1093/gerona/glt099.

Clave P, Verdaguer A, Arreola V. [Oral-pharyngeal dysphagia

in the elderly]. Med Clin (Barc) 2005;124:742-8. doi:

1157/13075447

Smith HA, Lee SH, O’Neill PA, Connolly MJ. The

combination of bedside swallowing assessment and oxygen

saturation monitoring of swallowing in acute stroke: a safe

and humane screening tool. Age Ageing 2000;29:495-9. doi:

1093/ageing/29.6.495

DePippo KL, Holas MA, Reding MJ. The Burke dysphagia

screening test: validation of its use in patients with stroke.

Arch Phys Med Rehabil 1994;75:1284-6. doi: 10.1007/

BF00366390

Belafsky PC, Mouadeb DA, Rees CJ, et al. Validity

and reliability of the Eating Assessment Tool (EAT-

. Ann Otol Rhinol Laryngol 2008;117:919-24. doi:

1177/000348940811701210

Burgos R, Sarto B, Segurola H, et al. [Translation and

validation of the Spanish version of the EAT-10 (Eating

Assessment Tool-10) for the screening of dysphagia]. Nutr

Hosp 2012;27:2048-54. doi: 10.3305/nh.2012.27.6.6100

Cheney DM, Siddiqui MT, Litts JK, Kuhn MA, Belafsky

PC. The ability of the 10-Item Eating Assessment Tool

(EAT-10) to predict aspiration risk in persons with

dysphagia. Ann Otol Rhinol Laryngol 2015;124:351-4. doi:

1177/0003489414558107

Kawashima K, Motohashi Y, Fujishima I. Prevalence of

dysphagia among community-dwelling elderly individuals

as estimated using a questionnaire for dysphagia screening.

Dysphagia 2004;19:266-71. doi: 10.1007/s00455-004-0013-6

Roy N, Stemple J, Merrill RM, Thomas L. Dysphagia in the

elderly: preliminary evidence of prevalence, risk factors,

and socioemotional effects. Ann Otol Rhinol Laryngol

;116:858-65. doi: 10.1177/000348940711601112

M. Ercilla CR, M. Gayan, J.M. Arteche, B. Odriozola,

M.C. Bello, I. Barral. Prevalence of dysphagia in the older

using ‘Eating Assessment Tool-10’. Eur J Hosp Pharm

;19:205-6. doi: 10.1177/0003489414558107

Heijnen BJ, Speyer R, Bulow M, Kuijpers LM. ‘What About

Swallowing?’ Diagnostic performance of daily clinical

practice compared with the Eating Assessment Tool-10.

Dysphagia 2016;31:214-22. doi: 10.1007/s00455-015-9680-

Rofes L, Arreola V, Mukherjee R, Clave P. Sensitivity

and specificity of the Eating Assessment Tool and the

Volume-Viscosity Swallow Test for clinical evaluation

of oropharyngeal dysphagia. Neurogastroenterol Motil

;26:1256-65. doi: 10.1111/nmo.12382

Yang EJ, Kim MH, Lim JY, Paik NJ. Oropharyngeal

dysphagia in a community-based elderly cohort: the korean

longitudinal study on health and aging. J Korean Med Sci

;28:1534-9. doi: 10.3346/jkms.2013.28.10.1534.

Gonzalez-Fernandez M, Ottenstein L, Atanelov L, Christian

AB. Dysphagia after stroke: An overview. Curr Phys Med

Rehabil Rep 2013;1:187-96. doi: 10.1007/s40141-013-0017-y

Mann G, Hankey GJ, Cameron D. Swallowing function after

stroke: prognosis and prognostic factors at 6 months. Stroke

;30:744-8. doi: 10.1161/01.STR.30.4.744

Serra-Prat M, Palomera M, Gomez C, Sar-Shalom D, Saiz

A, Montoya JG, et al. Oropharyngeal dysphagia as a risk

factor for malnutrition and lower respiratory tract infection

in independently living older persons: a population-based

prospective study. Age Ageing 2012;41:376-81. doi:

1093/ageing/afs006

Don BR, Kaysen G. Serum albumin: relationship to

inflammation and nutrition. Semin Dial 2004;17:432-7. doi:

1111/j.0894-0959.2004.17603.x

Wakabayashi H, Matsushima M, Uwano R, Watanabe N,

Oritsu H, Shimizu Y. Skeletal muscle mass is associated with

severe dysphagia in cancer patients. J Cachexia Sarcopenia

Muscle 2015;6:351-7. doi: 10.1002/jcsm.12052

Groher ME. Dysphagia. Management: general principles

and guidelines. Dysphagia 1991;6:67-70. doi: 10.1007/

BF02493481

Sharma JC, Fletcher S, Vassallo M, Ross I. What influences

outcome of stroke--pyrexia or dysphagia? Int J Clin Pract

;55:17-20. doi:

Guyomard V, Fulcher RA, Redmayne O, Metcalf AK, Potter

JF, Myint PK. Effect of dysphasia and dysphagia on inpatient

mortality and hospital length of stay: a database study. J

Am Geriatr Soc 2009;57:2101-6. doi: 10.1111/j.1532-

2009.02526.x.




Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.