Fernanda Chiarion Sassi1, Gisele Chagas de Medeiros2, Lucas Santos Zambon3, Bruno Zilberstein4, Claudia Regina Furquim de Andrade1. 1. Faculdade de Medicina da Universidade de São Paulo, Departamento de Fonoaudiologia, Fisioterapia e Terapia Ocupacional, São Paulo, SP, Brasil. 2. Hospital das Clínicas da Universidade de São Paulo, Divisão de Fonoaudiologia, São Paulo, SP, Brasil. 3. Faculdade de Medicina da Universidade de São Paulo, Departamento de Clínica Médica, São Paulo, SP, Brasil. 4. Faculdade de Medicina da Universidade de São Paulo, Departamento de Gastroenterologia, São Paulo, SP, Brasil.
Abstract
OBJECTIVE: to identify factors associated with dysphagia in patients undergoing prolonged orotracheal intubation (pOTI) and the post-extubation consequences. METHODS: 150 patients undergoing pOTI participated in the study, evaluated according to the deglutition functional level (American Speech Language - Hearing Association National Outcome Measurement System - ASHA NOMS), severity determination (The Simplified Acute Physiology Score - SOFA) and submitted to collection of variables age, mortality, days of orotracheal intubation, number of sessions to introduce oral diet, and days to hospital discharge. We grouped patients according to ASHA classification: 1 (levels 1 and 2), 2 (levels 3, 4 and 5) and 3 (levels 6 and 7). RESULTS: the variables associated with impaired deglutition functionality were age (p<0.001), mortality (p<0.003), OTI days (p=0.001), number of sessions to introduce oral diet (p<0.001) and days to hospital discharge (p=0.018). Multiple comparisons indicated significant difference between ASHA1 and ASHA2 groups in relation to ASHA3 group. ASHA1 and ASHA2 groups had a lower SOFA score when compared with the ASHA3 group (p=0.004). Only 20% of ASHA1 patients and 32% of ASHA2 patients presented safe deglutition levels before discharge. CONCLUSION: factors associated with dysphagia in patients submitted to pOTI were age over 55 years and orotracheal intubation time (greater in the cases with worse deglutition functionality). The post-extubation consequences were increased mortality and length of hospital stay in the presence of dysphagia.
OBJECTIVE: to identify factors associated with dysphagia in patients undergoing prolonged orotracheal intubation (pOTI) and the post-extubation consequences. METHODS: 150 patients undergoing pOTI participated in the study, evaluated according to the deglutition functional level (American Speech Language - Hearing Association National Outcome Measurement System - ASHA NOMS), severity determination (The Simplified Acute Physiology Score - SOFA) and submitted to collection of variables age, mortality, days of orotracheal intubation, number of sessions to introduce oral diet, and days to hospital discharge. We grouped patients according to ASHA classification: 1 (levels 1 and 2), 2 (levels 3, 4 and 5) and 3 (levels 6 and 7). RESULTS: the variables associated with impaired deglutition functionality were age (p<0.001), mortality (p<0.003), OTI days (p=0.001), number of sessions to introduce oral diet (p<0.001) and days to hospital discharge (p=0.018). Multiple comparisons indicated significant difference between ASHA1 and ASHA2 groups in relation to ASHA3 group. ASHA1 and ASHA2 groups had a lower SOFA score when compared with the ASHA3 group (p=0.004). Only 20% of ASHA1 patients and 32% of ASHA2 patients presented safe deglutition levels before discharge. CONCLUSION: factors associated with dysphagia in patients submitted to pOTI were age over 55 years and orotracheal intubation time (greater in the cases with worse deglutition functionality). The post-extubation consequences were increased mortality and length of hospital stay in the presence of dysphagia.
Authors: Peter E Spronk; Laura E J Spronk; Ingrid Egerod; Jennifer McGaughey; Jackie McRae; Louise Rose; Martin B Brodsky Journal: Dysphagia Date: 2022-01-29 Impact factor: 3.438