Incidence of Dysphagia and Its Association With Functional Recovery and 1-Year Mortality in Hospitalized Older Patients With Heart Failure: A Prospective Cohort Study.

Abstract

Dysphagia following heart failure (HF) has gained little attention. This study aimed to evaluate the incidence of dysphagia and its associations with the clinical outcomes in HF patients. This prospective cohort study included 203 consecutive hospitalized HF patients (mean age 79.5 years, 103 women) without dysphagia before admission. Dysphagia or difficulty swallowing was assessed by the Food Intake Level Scale. The primary outcome was activity of daily living, as assessed by the Barthel Index (BI) at discharge. Secondary outcomes included all-cause mortality and rehospitalization rates at 1 year after discharge. Multivariate analyses and Kaplan-Meier estimates were used to determine whether dysphagia was associated with these outcomes. Of the 203 patients examined, 48 (23.4%) were diagnosed with dysphagia during admission. Patients who developed dysphagia were significantly older, exhibited lower muscle mass and strength, walked shorter distances, and had lower nutrition intake levels and BI scores (P < 0.05 for all values) compared with those without dysphagia. In the multivariate analyses, the presence of dysphagia at discharge was significantly associated with a lower BI (β= -0.275, P < 0.001). Furthermore, patients with dysphagia showed a significantly higher 1-year mortality than those without (20.8% vs 1.2%, P = 0.008). Dysphagia commonly occurs during hospital admission and is associated with functional recovery and 1-year mortality in HF patients.