The importance of dysphagia screening and nutritional assessment in hospitalized patients

ABSTRACT Objective: To determine frequency of dysphagia risk and associated factors in hospitalized patients as well as to evaluate nutritional status by using different methods and correlate the status with scores of the Eating Assessment Tool (EAT-10). Methods: This was a cross-sectional study including 909 inpatients of a philanthropic hospital. For the diagnosis of dysphagia we used an adapted and validated Brazilian version of the Eating Assessment Tool (EAT-10). The nutritional status was evaluated through the subjective global assessment, and anthropometric measurements included weight, calf and arm circumference, and knee height. The Mann-Whitney test, associations using the Pearson’s χ2 and Spearman’s correlation were used to verify differences between the groups. Results: The prevalence of dysphagia risk was 10.5%, and aging was the associated factor with this condition. Patients at risk presented lower values of arm and calf circumference, variables that correlated inversely with the Eating Assessment Tool (EAT-10) score. Malnutrition was observed in 13.2% of patients based on the subjective global assessment and in 15.2% based on the Body Mass Index. Conclusion: Screening for dysphagia and malnutrition should be introduced in hospitals routine to avoid or minimize damages caused by dysphagia or malnutrition, especially among older people.

摘要

目的：明确住院患者吞咽障碍风险的发生率及其相关影响因素，采用多种方法评估患者营养状况，并将营养状况与进食评估工具（Eating Assessment Tool, EAT-10）评分进行关联分析。

方法：本研究为横断面研究，纳入某慈善医院的909名住院患者。吞咽障碍诊断采用经过调整并验证的巴西版进食评估工具（Eating Assessment Tool, EAT-10）。营养状况评估采用主观全面评定法，人体测量学指标包括体重、小腿围、臂围及膝高。采用曼-惠特尼U检验、皮尔逊卡方检验及斯皮尔曼相关性分析验证组间差异。

结果：吞咽障碍风险的患病率为10.5%，年龄增长是该病症的相关影响因素。存在吞咽障碍风险的患者臂围与小腿围数值更低，且上述指标与进食评估工具（EAT-10）评分呈负相关。基于主观全面评定法，13.2%的患者存在营养不良；基于体质量指数（Body Mass Index, BMI），该比例为15.2%。

结论：医院应将吞咽障碍与营养不良筛查纳入日常诊疗流程，以避免或减轻吞咽障碍或营养不良所带来的损害，尤其针对老年人群。