Risk factors for oropharyngeal dysphagia in cardiovascular diseases

Abstract Some conditions consolidated as risk factors for oropharyngeal dysphagia have already been identified in other diseases, such as neurological. Studies on cardiovascular diseases concentrate in individuals in the postoperative period; thus, it is unknown if these same factors occur in individuals hospitalized for clinical or surgical treatment of these diseases. Objective to correlate predictive risk factors for oropharyngeal dysphagia in individuals with cardiovascular disease admitted at a reference cardiology hospital. Methodology This is a retrospective clinical study. Medical records of 175 individuals hospitalized for clinical and/or surgical treatment at a reference cardiology hospital from January to June 2017, attendants of the Speech-Language Pathology and Nutrition team, were analyzed. Of these, 100 records were included in the study: 41 females and 59 males (mean age 67.56 years). Deaths and individuals from 0 to 18 years were excluded. Stroke, malnutrition, age and prolonged orotracheal intubation were considered predictive risk factors for oropharyngeal dysphagia. Mann-Whitney test and Fisher's test were used for statistical analysis. Results Stroke (OR=2.93 p=0.02), malnutrition (OR=2.89 p=0.02) and prolonged orotracheal intubation (OR=3.94 p=0.02) were statistically significant predictors for oropharyngeal dysphagia within this population. Age below 80 years was not significant (p=0.06), but within octogenarians, significance was found (p=0.033). Conclusion Stroke, malnutrition, prolonged orotracheal intubation and age > 80 years are predictive risk factors for oropharyngeal dysphagia in adult population with cardiovascular diseases.

摘要 已有研究在包括神经系统疾病在内的其他疾病中，明确了若干可归类为口咽吞咽障碍（oropharyngeal dysphagia）风险因素的病症。现有针对心血管疾病的相关研究多聚焦于术后患者群体，因此尚不明确这些风险因素是否同样适用于因这类疾病接受内科或外科治疗的住院患者。
目的 探讨某参考心脏病医院收治的心血管疾病患者中，与口咽吞咽障碍相关的预测性风险因素。
方法 本研究为回顾性临床研究。分析了2017年1月至6月期间，于该参考心脏病医院接受内科和/或外科治疗、且接受言语-语言病理与营养团队诊疗服务的175份住院患者病历。最终纳入100份有效病历：其中女性41例，男性59例，平均年龄67.56岁。本研究排除死亡病例及0至18岁的受试者。研究将脑卒中、营养不良、年龄及长期经口气管插管列为口咽吞咽障碍的预测性风险因素。统计学分析采用曼-惠特尼检验（Mann-Whitney test）与费希尔精确检验（Fisher's test）。
结果 本研究人群中，脑卒中（OR=2.93，P=0.02）、营养不良（OR=2.89，P=0.02）及长期经口气管插管（OR=3.94，P=0.02）均为口咽吞咽障碍具有统计学意义的预测因素。年龄低于80岁无显著相关性（P=0.06），但在80岁及以上老年人群中则呈现显著关联（P=0.033）。
结论 脑卒中、营养不良、长期经口气管插管及年龄＞80岁，均为心血管疾病成年人群发生口咽吞咽障碍的预测性风险因素。