Dysphagia Profiles Among Inpatients with Dementia Referred for Swallow Evaluation.
Dysphagia Profiles Among Inpatients with Dementia Referred for Swallow Evaluation.
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DOI：
10.3233/jad-220402
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发表时间：
2022
影响因子：
4
通讯作者：
Rogus-Pulia, Nicole
中科院分区：
文献类型：
--
作者：
Wang, Steven;Gustafson, Sara;Deckelman, Celia;Sampene, Emmanuel;Daggett, Sarah;Loosen, Julia;Robison, Raele;Pulia, Michael S.;Knigge, Molly;Thibeault, Susan;Gilmore-Bykovskyi, Andrea;Kind, Amy;Rogus-Pulia, Nicole
阿尔茨海默病和相关痴呆（ADRD）患者住院治疗时经常发生口咽吞咽困难，增加了不良结局（如吸入性肺炎）的风险。然而，吞咽困难的患病率估计是高度可变的，并且通常基于患者报告或临床测试，而不是吞咽的可视化。本研究的目的是确定吞咽困难的患病率和严重程度与ADRD住院患者提到吞咽评价。ADRD诊断的电子健康记录（EHR）摘要以及床旁吞咽评价（BSE）和视频透视吞咽研究（VFSS）中临床确定的吞咽困难的存在和严重程度。16%（n = 268）有ADRD诊断或正在服用基于EHR的痴呆特异性药物。 75%（n = 202）在BSE上被诊断为吞咽困难。 60%随后接受了VFSS（n = 122），92%（n = 112）确认吞咽困难。 ADRD住院患者根据BSE（p <0.0001）诊断为吞咽困难的可能性显著高于无ADRD的患者。 此外，ADRD组VFSS上的吞咽困难更严重（p <0.03）。 ADRD个体在住院期间可能容易发生吞咽困难或吞咽困难恶化。结果强调了评估ADRD住院患者吞咽功能的重要性，以促进有针对性的干预。
Alzheimer’s disease and related dementias (ADRD) patients who are hospitalized often develop oropharyngeal dysphagia, increasing risk for adverse outcomes, such as aspiration pneumonia. However, prevalence estimates of dysphagia are highly variable and often based on patient report or clinical testing rather than visualization of the swallow. The aims of this study were to determine prevalence and severity of dysphagia among inpatients with ADRD referred for swallowing evaluation. Electronic health record (EHR) abstraction of ADRD diagnosis and presence and severity of clinically-determined dysphagia on bedside swallow evaluation (BSE) and videofluoroscopic swallow study (VFSS). 16% (n = 268) had an ADRD diagnosis or were taking dementia-specific medication based on the EHR. 75% (n = 202) were diagnosed with dysphagia on the BSE. 60% subsequently underwent VFSS (n = 122) with dysphagia confirmation in 92% (n = 112). ADRD inpatients were significantly more likely to be diagnosed with dysphagia based on the BSE (p < 0.0001) than those without ADRD. Additionally, dysphagia on the VFSS was more severe in the ADRD group (p < 0.03). ADRD individuals may be vulnerable to developing or worsening dysphagia during hospitalization. Results underscore the importance of evaluating swallowing function in hospitalized patients with ADRD in order to facilitate targeted intervention.