Negative outcomes occur early among geriatric patients with early signs of dysphagia in an acute care setting

Abstract

Objectives: This study aimed to investigate the clinical outcomes associated with early signs of dysphagia (SD) in geriatric patients in an acute care setting. Methods: In this prospective observational study with 18 mo follow-up, geriatric patients were screened for early signs of dysphagia in an acute care setting. Included patients were grouped based on swallowing function—SD or normal swallowing (NS). Follow-up data were retrieved from medical records on 332 patients with complete screening from baseline to 18 mo after admission. Results: Among participants, 52.0% were male, median age was 79 (25th percentile 73.0; 75th percentile 85.0) y and median BMI was 26.1 (22.4;29.8) kg/m 2. Patients with early SD had higher mortality (41.3%) compared with NS (23.3%) (P &lt; 0.001). Both mortality and readmissions occurred within the first 90 d after screening compared with after 90 d. Using multiple hazard regression analyses, risk factors for mortality were identified as increasing age, SD, nutritional risk, low performance status, increasing number of comorbidities, and inflammation markers (P &lt; 0.05). Furthermore, low performance status, a high number of comorbidities, and low hemoglobin were risk factors for readmissions within the 18 mo follow-up period (P &lt; 0.05). Conclusions: Early SD were associated with mortality after 18 mo, but readmissions were mostly pronounced within 90 d. Early dysphagia screening in older patients in general is relevant in the acute care setting as part of nursing care activities.</p