Dysphagia worsens short-term outcomes in patients with acute exacerbation of heart failure

被引:11
作者
Yokota, Junichi [1 ,2 ]
Ogawa, Yoshiko [3 ]
Takahashi, Yoshimi [4 ]
Yamaguchi, Nobuhiro [4 ]
Onoue, Noriko [4 ]
Shinozaki, Tsuyoshi [4 ]
Kohzuki, Masahiro [1 ]
机构
[1] Tohoku Univ, Grad Sch Med, Dept Internal Med & Rehabil Sci Disabil Sci, Aoba Ku, 1-1 Seiryo Cho, Sendai, Miyagi 9808574, Japan
[2] Sendai Med Ctr, Natl Hosp Org, Dept Rehabil, Sendai, Miyagi, Japan
[3] Teikyo Univ, Dept Sport & Med Sci, Hachioji, Tokyo, Japan
[4] Sendai Med Ctr, Natl Hosp Org, Dept Cardiol, Sendai, Miyagi, Japan
关键词
Dysphagia; Heart failure; Functional oral intake scale; Short-term outcomes; IN-HOSPITAL MORTALITY; CLINICAL CHARACTERISTICS; OROPHARYNGEAL DYSPHAGIA; JAPAN; ASSOCIATION; DYSFUNCTION; PREDICTORS; MANAGEMENT; SOCIETY;
D O I
10.1007/s00380-020-01617-w
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Dysphagia, defined as a dysfunction in any stage or process of eating, is common in patients with acute exacerbation of heart failure (HF). In some diseases, dysphagia worsens in-hospital mortality, length of hospital stay, and discharge disposition. However, it remains unclear whether dysphagia is associated with poor short-term outcomes in HF patients. The objective of the present study was to determine whether dysphagia affects short-term outcomes in patients with acute exacerbation of HF. A total of 327 patients hospitalized with acute exacerbation of HF were eligible for the study. Patients were divided into a dysphagia group (DG) or a non-dysphagia group (NDG) based on results of the functional oral intake scale (FOIS), which evaluates a patient's ability of eating and swallowing. FOIS is a 7-point scale, with a level of <= 5 indicating dysphagia. Following the withdrawal of 16 patients, short-term outcomes such as in-hospital mortality, length of hospital stay, and discharge disposition, of 311 patients were analyzed. All indexes of short-term outcomes were significantly worse in the DG than in the NDG. After propensity score matching, which was performed to adjust for baseline characteristics such as age, sex, height, weight, body mass index, medical history, complications, HF severity, ejection fraction, and biochemical data excluding nutritional status, all short-term outcomes remained significantly worse in the DG than in the NDG. Multivariate analysis showed that FOIS was an independent predictor of in-hospital survival, length of hospital stay, and discharge to home. The present study suggested that dysphagia affected short-term outcomes in patients with acute exacerbation of HF. Therefore, early detection and intervention of dysphagia in HF patients are important.
引用
收藏
页码:1429 / 1438
页数:10
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