Martin B Brodsky1, Jonathan E Gellar2, Victor D Dinglas3, Elizabeth Colantuoni2, Pedro A Mendez-Tellez4, Carl Shanholtz5, Jeffrey B Palmer6, Dale M Needham7. 1. Department of Physical Medicine and Rehabilitation, Johns Hopkins University, Baltimore, MD; Outcomes After Critical Illness and Surgery Research Group, Johns Hopkins University, Baltimore, MD. 2. Outcomes After Critical Illness and Surgery Research Group, Johns Hopkins University, Baltimore, MD; Department of Biostatistics, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD. 3. Outcomes After Critical Illness and Surgery Research Group, Johns Hopkins University, Baltimore, MD; Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, MD. 4. Outcomes After Critical Illness and Surgery Research Group, Johns Hopkins University, Baltimore, MD; Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University, Baltimore, MD. 5. Division of Pulmonary and Critical Care Medicine, University of Maryland, Baltimore, MD. 6. Department of Physical Medicine and Rehabilitation, Johns Hopkins University, Baltimore, MD; Department of Otolaryngology-Head and Neck Surgery and Center for Functional Anatomy and Evolution, Johns Hopkins University, Baltimore, MD. 7. Department of Physical Medicine and Rehabilitation, Johns Hopkins University, Baltimore, MD; Outcomes After Critical Illness and Surgery Research Group, Johns Hopkins University, Baltimore, MD; Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, MD. Electronic address: dale.needham@jhmi.edu.
Abstract
PURPOSE: The purpose of this study is to evaluate demographic and clinical factors associated with self-reported dysphagia after oral endotracheal intubation and mechanical ventilation in patients with acute lung injury (ALI). MATERIALS AND METHODS: This is a prospective cohort study of 132 ALI patients who had received mechanical ventilation via oral endotracheal tube. RESULTS: The primary outcome was binary, whether clinically important symptoms of dysphagia at hospital discharge were reported by patients, using the Sydney Swallowing Questionnaire score 200 or more. Of 132 patients, 29% reported clinically important symptoms of dysphagia. Of 18 relevant demographic and clinical variables, only 2 were found to be independently associated with clinically important symptoms of dysphagia in a multivariable logistic regression model: upper gastrointestinal comorbidity (odds ratio, 2.82; 95% confidence interval, 1.09-7.26) and duration of oral endotracheal intubation (odds ratio, 1.79; [95% confidence interval, 1.15-2.79] per day for first 6 days, after which additional days of intubation were not associated with a further increase in the odds of dysphagia). CONCLUSIONS: In ALI survivors, patient-reported, postexubation dysphagia at hospital discharge was significantly associated with upper gastrointestinal comorbidity and a longer duration of oral endotracheal intubation during the first 6 days of intubation.
PURPOSE: The purpose of this study is to evaluate demographic and clinical factors associated with self-reported dysphagia after oral endotracheal intubation and mechanical ventilation in patients with acute lung injury (ALI). MATERIALS AND METHODS: This is a prospective cohort study of 132 ALI patients who had received mechanical ventilation via oral endotracheal tube. RESULTS: The primary outcome was binary, whether clinically important symptoms of dysphagia at hospital discharge were reported by patients, using the Sydney Swallowing Questionnaire score 200 or more. Of 132 patients, 29% reported clinically important symptoms of dysphagia. Of 18 relevant demographic and clinical variables, only 2 were found to be independently associated with clinically important symptoms of dysphagia in a multivariable logistic regression model: upper gastrointestinal comorbidity (odds ratio, 2.82; 95% confidence interval, 1.09-7.26) and duration of oral endotracheal intubation (odds ratio, 1.79; [95% confidence interval, 1.15-2.79] per day for first 6 days, after which additional days of intubation were not associated with a further increase in the odds of dysphagia). CONCLUSIONS: In ALI survivors, patient-reported, postexubation dysphagia at hospital discharge was significantly associated with upper gastrointestinal comorbidity and a longer duration of oral endotracheal intubation during the first 6 days of intubation.
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