OP018 ASSOCIATION BETWEEN OROPHARYNGEAL DYSPHAGIA AND MALNUTRITION IN ELDERLY PATIENTS WITH ACUTE DISEASES ADMITTED TO A GENERAL HOSPITAL

Abstract

Rationale: To determine the relationship between oropharyngeal dysphagia (OD), nutritional status and clinical outcome in elderly patients with acute diseases admitted to a general hospital. Methods: Prospective observational study of 1662 patients over 70 years of age consecutively hospitalized in an acute geriatric unit (AGU) in a general hospital. Dysphagia was clinically assessed with the volumeviscosity swallow test (V-VST) and nutritional status with the Mini Nutritional Assessment. Other measurements taken during admission were anthropometry and laboratory values, comorbidities (Charlson index), cognitive status (Pfeiffer) and functional capacity (Barthel index). Mortality during admission, referral to nursing homes and mortality at 12 months after discharge were also monitored. Results: Up to 52.6% patients admitted to the AGU presented clinical signs of OD and a) more comorbidities (2.42+1.6 vs 2.02+1.6 p < 0.001), poorer functionality both pre-admission and at discharge (p < 0.001), more geriatric syndromes (93.3% vs 72.5% p < 0.001) and poorer outcome (1 year mortality 48.7 vs 25.1%) (p < 0.001) and b) higher prevalence of malnutrition (MNA< 17 45.3% vs 18%, p < 0.001; BMI 25.5 vs 26.8, p < 0.001) and albumin <3 g/dl (62.9% vs 37.1%, p < 0.001). Regardless of their functional status and comorbidities, elderly patients with OD were at increased risk of malnutrition (OR 2.31 (1.70 3.14)), referral to nursing homes (OR 1.57 (1.12 2.19)) and increased mortality one year after discharge (OR 1.91 (1.48 2.46)). Conclusion: Oropharyngeal dysphagia is a very prevalent disease among elderly patients with acute diseases admitted to a general hospital, and is closely related to high prevalence of malnutrition and poor outcome.