Abstract
Swallowing disorders are common in hospitalized patients. Functional endoscopic evaluation of swallowing (FEES) is a simple, safe and effective test for the diagnosis and monitoring of these disorders.To report the results of functional endoscopic swallowing evaluation.Retrospective review of all records of functional swallowing evaluation procedures performed in a 6 months period.A total of 327 evaluations were analyzed. Sixty seven percent were performed for the first time in a patient and 32.4% were follow-up evaluations. Mean age of patients was 73 ± 17 (SD) years and 56% were male. Twenty nine percent had prolonged orotracheal intubation (> 48 hours). Swallowing was evaluated as normal, mildly, moderately and severely altered in 8.2, 27, 27 and 38% of cases, respectively. Age (> 50 years) and orotracheal intubation were the most important predictors of severity (p = 0,01). Oral feeding was achieved during hospital stay in 78 and 55 % of patients with moderate or severe swallowing disorders, respectively, after a delay of 8.7 and 14.3 days, respectively. Having a severe swallowing disorder during the first evaluation, increased fourfold the risk of gastrostomy.Most hospitalized patients with swallowing disorders achieve oral feeding before leaving hospital. Safe oral feeding is delayed as swallowing disorder is of greater severity.
Highlights
A mayor severidad del trastorno deglutorio, menores fueron las posibilidades de egresar con alimentación por vía oral (VO) (78% para los trastornos moderados, y 55% para los severos, p = 0,03), y mayor probabilidad de terminar con gastrostomía (GTT) como vía de alimentación al egreso hospitalario (5,6 vs 21,4%, p = 0,05)
Assessments of dysphagia and aspiration risk in acute stroke patients
Summary
Evaluación de la deglución con nasofibroscopia en pacientes hospitalizados: factores predictivos y seguimiento intrahospitalario. Oral feeding was achieved during hospital stay in 78 and 55 % of patients with moderate or severe swallowing disorders, respectively, after a delay of 8.7 and 14.3 days, respectively. Departamento de Otorrinolaringología, Pontificia Universidad Católica de Chile. Centro de Especialidades Médicas, Pontificia Universidad Católica de Chile. La incidencia de trastornos de la deglución está en aumento en Chile y el mundo, entre otras causas por el aumento sostenido de la población mayor de 65 años (7,9% de la población chilena en el 2005)[5], la mayor presencia de comorbilidades asociadas, y la mejor sobrevida de patologías que provocan secuelas, como el accidente vascular encefálico (AVE), que pueden presentar disfagia hasta en 80% de los casos, dependiendo del método diagnóstico utilizado[6,7,8]. Se ha postulado que el nervio laríngeo superior (rama del nervio vago) es el principal encargado de la sensibilidad laríngea y sería el mayor responsable en el gatillo del reflejo de la
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