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Dysphagia
Published in: Dysphagia 5/2020

01-10-2020 | Dysphagia | Original Article

Association Between Dysphagia and Inpatient Outcomes Across Frailty Level Among Patients ≥ 50 Years of Age

Authors: Seth M. Cohen, Deborah Lekan, Thomas Risoli Jr., Hui-Jie Lee, Stephanie Misono, Heather E. Whitson, Sudha Raman

Published in: Dysphagia | Issue 5/2020

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Abstract

Frail patients may have heightened risk of dysphagia, a potentially modifiable health factor. Our aim is to examine whether the relationship between dysphagia and adverse health outcomes differs by frailty conditions among inpatients ≥ 50 years of age. Medical or surgical hospitalizations among patients ≥ 50 years of age in the Healthcare Cost and Utilization Project’s National Inpatient Sample from 2014 through the first three quarters of 2015 were included. Adverse outcomes included length of stay (LOS), hospital costs, in-hospital mortality, discharge status, and medical complications. Dysphagia was determined by ICD-9-CM codes. Frailty was defined as (a) ≥ 1 condition in the10-item Johns Hopkins Adjusted Clinical Groups (ACG) frailty measure and a frailty index for the (b) ACG and (c) a 19-item Frailty Risk Score (FRS) categorized as non-frail, pre-frail, and frail. Weighted generalized linear models for complex survey designs using generalized estimating equations were performed. Of 6,230,114 unweighted hospitalizations, 4.0% had a dysphagia diagnosis. Dysphagia presented in 3.1% and 11.0% of non-frail and frail hospitalizations using the binary ACG (p < 0.001) and in 2.9%, 7.9%, and 16.0% of non-frail, pre-frail, and frail hospitalizations using the indexed FRS (p < 0.001). Dysphagia was associated with greater LOS, higher total costs, increased non-routine discharges, and more medical complications among both frail and non-frail patients using the three frailty definitions. Dysphagia was associated with adverse outcomes in both frail and non-frail medical or surgical hospitalizations. Dysphagia management is an important consideration for providers seeking to reduce risk in vulnerable populations.
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Metadata
Title
Association Between Dysphagia and Inpatient Outcomes Across Frailty Level Among Patients ≥ 50 Years of Age
Authors
Seth M. Cohen
Deborah Lekan
Thomas Risoli Jr.
Hui-Jie Lee
Stephanie Misono
Heather E. Whitson
Sudha Raman
Publication date
01-10-2020
Publisher
Springer US
Published in
Dysphagia / Issue 5/2020
Print ISSN: 0179-051X
Electronic ISSN: 1432-0460
DOI
https://doi.org/10.1007/s00455-019-10084-z

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