Hospital management of the patient with dysphagia. Survey and recommendations of SEEN nutrition area

Abstract

IntroductionThe prevalence of dysphagia in hospitalized patients is extraordinarily high and little known. The goal of care should be to assess the efficacy and safety of swallowing, to indicate personalized nutritional therapy. The development of Dysphagia Units, as a multidisciplinary team, facilitates comprehensive care for this type of patient. Material and methodsA observational, cross-sectional, web-based survey-type study, focused on Spanish Society of Endocrinology and Nutrition department heads, was conducted in September-October 2021. The following data were analyzed: size and type of center, existence of a dysphagia unit, dysphagia screening, dietary and nutritional therapy, education and training of professionals and patients, codification, and quality of life evaluation. Results65 responses (39% of the total Endocrinology and Nutrition departments). 37% of hospitals have a Dysphagia Unit and 25% are developing it. 75.4% perform screening, with MECV-V in 80.6%, and VED (61.4%) and VFS (54.4%) are performed as main complementary tests. The centers have different models of oral diet, thickeners and nutritional oral supplements adapted to dysphagia. In 40% of the centers, no information is offered on dysphagia, nor on the use of thickeners, dysphagia is coded in 81%, 52.3% have specific nursing protocols and only 8% have scales for quality-of-life evaluation. ConclusionsThe high prevalence and the risk of serious complications require early and multidisciplinary management at the hospital level. The information received by the patient and caregiver about the dietary adaptations they need, is essential to minimize risks and improve quality of life.