Temporal recovery and prognostic factors for dysphagia following cardiovascular surgery: Retrospective analysis and development of predictive score.

Cariovascular surgery Dysphagia Nutritional management Postextubation dysphagia Swallowing rehabilitation

Journal

Nutrition (Burbank, Los Angeles County, Calif.)
ISSN: 1873-1244
Titre abrégé: Nutrition
Pays: United States
ID NLM: 8802712

Informations de publication

Date de publication:
18 Jul 2024
Historique:
received: 01 05 2024
revised: 03 07 2024
accepted: 13 07 2024
medline: 22 8 2024
pubmed: 22 8 2024
entrez: 21 8 2024
Statut: aheadofprint

Résumé

Dysphagia is a common complication associated with cardiovascular surgery (CVS). This study sought to better understand recovery timelines, identify risk factors, and create a prognostic model for oral intake restoration. This retrospective study included 134 patients who had CVS between April 2022 and March 2024. We assessed swallowing ability through fiberoptic endoscopic evaluation of swallowing (FEES). We randomly divided the patients' data into a training dataset and a test dataset in a ratio of 70/30 and Kaplan-Meier analyses and Cox regression were used to assess predictors of total oral intake. We also created a scoring system using the estimated regression coefficients. Most patients with CVS achieved total oral intake in 7-11 days after extubation. Over 168 h of intubation, the presence of penetration or aspiration, a poor FEES score (score > 6), and perioperative complications were significant risk factors for delayed total oral intake. The predicting score was calculated by adding the scores for each individual factor, including FEES score, penetration/aspiration, and preoperative complications. Scores ranged 0-8, categorizing patients into 0-2, 3-5, and 6-8 groups, clearly demonstrating that the higher the predicting score, the longer the time to total oral intake in both the training and the test dataset. All risk factors for unsuccessful or delayed total oral intake were intubation for more than a week, poor swallowing ability, and the presence of perioperative complications. The scoring system accurately predicts the restoration of oral intake following CVS.

Identifiants

pubmed: 39168041
pii: S0899-9007(24)00183-7
doi: 10.1016/j.nut.2024.112534
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

112534

Informations de copyright

Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Auteurs

Nao Hashida (N)

Swallowing Center, Osaka University Hospital, Suita city, Osaka, Japan. Electronic address: nhashida@ent.med.osaka-u.ac.jp.

Kiyohito Hosokawa (K)

Swallowing Center, Osaka University Hospital, Suita city, Osaka, Japan; Department of Otorhinolaryngology-Head and Neck Surgery, Osaka University Graduate School of Medicine, Suita City, Osaka, Japan.

Ai Kawamura (A)

Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine, Suita City, Osaka, Japan.

Motoyuki Suzuki (M)

Swallowing Center, Osaka University Hospital, Suita city, Osaka, Japan; Department of Otorhinolaryngology-Head and Neck Surgery, Osaka University Graduate School of Medicine, Suita City, Osaka, Japan.

Itsuki Kitayama (I)

Swallowing Center, Osaka University Hospital, Suita city, Osaka, Japan; Department of Otorhinolaryngology-Head and Neck Surgery, Osaka University Graduate School of Medicine, Suita City, Osaka, Japan.

Masayuki Nozawa (M)

Swallowing Center, Osaka University Hospital, Suita city, Osaka, Japan; Department of Otorhinolaryngology-Head and Neck Surgery, Osaka University Graduate School of Medicine, Suita City, Osaka, Japan.

Eri Okajima (E)

Swallowing Center, Osaka University Hospital, Suita city, Osaka, Japan; Department of Otorhinolaryngology-Head and Neck Surgery, Osaka University Graduate School of Medicine, Suita City, Osaka, Japan.

Madoka Sugamoto (M)

Swallowing Center, Osaka University Hospital, Suita city, Osaka, Japan; Department of Rehabilitation, Osaka University Hospital, Suita city, Osaka, Japan.

Akinari Sugauchi (A)

Swallowing Center, Osaka University Hospital, Suita city, Osaka, Japan; Unit of Dentistry, Osaka University Hospital, Suita city, Osaka, Japan.

Wataru Sahara (W)

Swallowing Center, Osaka University Hospital, Suita city, Osaka, Japan; Department of Rehabilitation, Osaka University Hospital, Suita city, Osaka, Japan.

Shigeru Miyagawa (S)

Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine, Suita City, Osaka, Japan.

Hidenori Inohara (H)

Swallowing Center, Osaka University Hospital, Suita city, Osaka, Japan; Department of Otorhinolaryngology-Head and Neck Surgery, Osaka University Graduate School of Medicine, Suita City, Osaka, Japan.

Classifications MeSH