Skip to main content
Top
Published in: Dysphagia 3/2017

01-06-2017 | Original Article

The Prevalence of Oropharyngeal Dysphagia in Danish Patients Hospitalised with Community-Acquired Pneumonia

Authors: Dorte Melgaard, Ulrik Baandrup, Martin Bøgsted, Mette Dahl Bendtsen, Tina Hansen

Published in: Dysphagia | Issue 3/2017

Login to get access

Abstract

Community-acquired pneumonia (CAP) and oropharyngeal dysphagia (OD) are prevalent conditions in the elderly. The aim of this study was to explore the relationship between CAP, OD, and frailty in patients admitted to a department of respiratory medicine at a regional hospital. The outcome was mortality during hospitalization and within 30 days of discharge and rehospitalization within 30 days of discharge. A total of 154 consecutive patients (54.5% male, mean age 77.4 years (SD 11.51)) hospitalized because of CAP from September 1, 2013 to March 31, 2014 at North Denmark Regional Hospital were included in this study. The volume-viscosity swallow test was conducted for each patient. A total of 34.42% patients presented with OD. Patients with OD and CAP presented significant differences in age, CURB-65, and dementia compared with those of patients with CAP alone. The majority lived in nursing homes, had a lower body mass index, Barthel 20 score, and handgrip strength, and had poor oral health compared with patients with CAP only. Patients with OD presented an increased length of stay in hospital (P < 0.001), intra-hospital mortality (P < 0.001), and 30-day mortality rate (P < 0.001) compared with those of patients with CAP only. Their rate of rehospitalization 0–30 days after discharge was also increased (P < 0.001) compared with that of patients with CAP only. Thus, OD is related to frailty and poor outcome.
Literature
1.
go back to reference Niederman MS, McCombs JS, Unger AN, Kumar A, Popovian R. The cost of treating community-acquired pneumonia. Clin Ther. 1998;4:820–37.CrossRef Niederman MS, McCombs JS, Unger AN, Kumar A, Popovian R. The cost of treating community-acquired pneumonia. Clin Ther. 1998;4:820–37.CrossRef
2.
go back to reference Carriere KC, Jin Y, Marrie TJ, Predy G, Johnson DH. Outcomes and costs among seniors requiring hospitalization for community-acquired pneumonia in Alberta. J Am Geriatr Soc. 2004;1:31–8.CrossRef Carriere KC, Jin Y, Marrie TJ, Predy G, Johnson DH. Outcomes and costs among seniors requiring hospitalization for community-acquired pneumonia in Alberta. J Am Geriatr Soc. 2004;1:31–8.CrossRef
3.
go back to reference Altman KW, Yu GP, Schaefer SD. Consequence of dysphagia in the hospitalized patient: impact on prognosis and hospital resources. Arch Otolaryngol Head Neck Surg. 2010;8:784–9.CrossRef Altman KW, Yu GP, Schaefer SD. Consequence of dysphagia in the hospitalized patient: impact on prognosis and hospital resources. Arch Otolaryngol Head Neck Surg. 2010;8:784–9.CrossRef
4.
go back to reference Langmore SE, Terpenning MS, Schork A, Chen Y, Murray JT, Lopatin D, Loesche WJ. Predictors of aspiration pneumonia: how important is dysphagia? Dysphagia. 1998;2:69–81.CrossRef Langmore SE, Terpenning MS, Schork A, Chen Y, Murray JT, Lopatin D, Loesche WJ. Predictors of aspiration pneumonia: how important is dysphagia? Dysphagia. 1998;2:69–81.CrossRef
6.
go back to reference Kaysar M, Augustine T, Jim L, Benjamin C. Predictors of length of stay between the young and aged in hospitalized community-acquired pneumonia patients. Geriatr Gerontol Int. 2008;4:227–33.CrossRef Kaysar M, Augustine T, Jim L, Benjamin C. Predictors of length of stay between the young and aged in hospitalized community-acquired pneumonia patients. Geriatr Gerontol Int. 2008;4:227–33.CrossRef
7.
go back to reference Christensen K, Doblhammer G, Rau R, Vaupel JW. Ageing populations: the challenges ahead. Lancet. 2009;9696:1196–208.CrossRef Christensen K, Doblhammer G, Rau R, Vaupel JW. Ageing populations: the challenges ahead. Lancet. 2009;9696:1196–208.CrossRef
8.
go back to reference Hibberd J, Fraser J, Chapman C, McQueen H, Wilson A. Can we use influencing factors to predict aspiration pneumonia in the United Kingdom? Multidiscip Respir Med. 2013;1:39–6958-8-39.CrossRef Hibberd J, Fraser J, Chapman C, McQueen H, Wilson A. Can we use influencing factors to predict aspiration pneumonia in the United Kingdom? Multidiscip Respir Med. 2013;1:39–6958-8-39.CrossRef
9.
go back to reference Roden DF, Altman KW. Causes of dysphagia among different age groups: a systematic review of the literature. Otolaryngol Clin North Am. 2013;6:965–87.CrossRef Roden DF, Altman KW. Causes of dysphagia among different age groups: a systematic review of the literature. Otolaryngol Clin North Am. 2013;6:965–87.CrossRef
11.
go back to reference Cabre M, Serra-Prat M, Force L, Almirall J, Palomera E, Clave P. Oropharyngeal dysphagia is a risk factor for readmission for Pneumonia in the very elderly persons: observational prospective study. J Gerontol Ser A. 2013;69(3):330–7. Cabre M, Serra-Prat M, Force L, Almirall J, Palomera E, Clave P. Oropharyngeal dysphagia is a risk factor for readmission for Pneumonia in the very elderly persons: observational prospective study. J Gerontol Ser A. 2013;69(3):330–7.
12.
go back to reference Torres A, Peetermans WE, Viegi G, Blasi F. Risk factors for community-acquired pneumonia in adults in Europe: a literature review. Thorax. 2013;11:1057–65.CrossRef Torres A, Peetermans WE, Viegi G, Blasi F. Risk factors for community-acquired pneumonia in adults in Europe: a literature review. Thorax. 2013;11:1057–65.CrossRef
13.
go back to reference World Health Organization: International Classification of Functioning, Disability and Health (ICF), 2001. World Health Organization: International Classification of Functioning, Disability and Health (ICF), 2001.
14.
go back to reference Serra-Prat M, Palomera M, Gomez C, Sar-Shalom D, Saiz A, Montoya JG, Navajas M, Palomera E, Clave P. Oropharyngeal dysphagia as a risk factor for malnutrition and lower respiratory tract infection in independently living older persons: a population-based prospective study. Age Ageing. 2012;3:376–81.CrossRef Serra-Prat M, Palomera M, Gomez C, Sar-Shalom D, Saiz A, Montoya JG, Navajas M, Palomera E, Clave P. Oropharyngeal dysphagia as a risk factor for malnutrition and lower respiratory tract infection in independently living older persons: a population-based prospective study. Age Ageing. 2012;3:376–81.CrossRef
15.
go back to reference Cook IJ. Oropharyngeal dysphagia. Gastroenterol Clin North Am. 2009;3:411–31.CrossRef Cook IJ. Oropharyngeal dysphagia. Gastroenterol Clin North Am. 2009;3:411–31.CrossRef
16.
go back to reference Takizawa C, Gemmell E, Kenworthy J, Speyer R: A systematic review of the prevalence of oropharyngeal dysphagia in stroke, Parkinson’s disease, Alzheimer’s disease, head injury, and pneumonia. Dysphagia. 2016;31(3):434–41.CrossRefPubMed Takizawa C, Gemmell E, Kenworthy J, Speyer R: A systematic review of the prevalence of oropharyngeal dysphagia in stroke, Parkinson’s disease, Alzheimer’s disease, head injury, and pneumonia. Dysphagia. 2016;31(3):434–41.CrossRefPubMed
17.
go back to reference Logemann J, Curro F, Pauloski B, Gensler G. Aging effects on oropharyngeal swallow and the role of dental care in oropharyngeal dysphagia. Oral Dis. 2013;19(8):733–7.CrossRefPubMed Logemann J, Curro F, Pauloski B, Gensler G. Aging effects on oropharyngeal swallow and the role of dental care in oropharyngeal dysphagia. Oral Dis. 2013;19(8):733–7.CrossRefPubMed
18.
go back to reference Carrion S, Cabre M, Monteis R, Roca M, Palomera E, Serra-Prat M, Rofes L, Clave P. Oropharyngeal dysphagia is a prevalent risk factor for malnutrition in a cohort of older patients admitted with an acute disease to a general hospital. Clin Nutr. 2014;34(3):436–42.CrossRefPubMed Carrion S, Cabre M, Monteis R, Roca M, Palomera E, Serra-Prat M, Rofes L, Clave P. Oropharyngeal dysphagia is a prevalent risk factor for malnutrition in a cohort of older patients admitted with an acute disease to a general hospital. Clin Nutr. 2014;34(3):436–42.CrossRefPubMed
19.
go back to reference Rofes L, Arreola V, Romea M, Palomera E, Almirall J, Cabre M, Serra-Prat M, Clave P: Pathophysiology of oropharyngeal dysphagia in the frail elderly. Neurogastroenterol Motil 8: 851-8, e230, 2010. Rofes L, Arreola V, Romea M, Palomera E, Almirall J, Cabre M, Serra-Prat M, Clave P: Pathophysiology of oropharyngeal dysphagia in the frail elderly. Neurogastroenterol Motil 8: 851-8, e230, 2010.
20.
go back to reference van der Maarel-Wierink CD, Vanobbergen JN, Bronkhorst EM, Schols JM, de Baat C. Meta-analysis of dysphagia and aspiration pneumonia in frail elders. J Dent Res. 2011;12:1398–404.CrossRef van der Maarel-Wierink CD, Vanobbergen JN, Bronkhorst EM, Schols JM, de Baat C. Meta-analysis of dysphagia and aspiration pneumonia in frail elders. J Dent Res. 2011;12:1398–404.CrossRef
21.
go back to reference Rockwood K, Song X, MacKnight C, Bergman H, Hogan DB, McDowell I, Mitnitski A. A global clinical measure of fitness and frailty in elderly people. CMAJ. 2005;5:489–95.CrossRef Rockwood K, Song X, MacKnight C, Bergman H, Hogan DB, McDowell I, Mitnitski A. A global clinical measure of fitness and frailty in elderly people. CMAJ. 2005;5:489–95.CrossRef
22.
go back to reference Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C, Gottdiener J, Seeman T, Tracy R, Kop WJ, Burke G, McBurnie MA. Cardiovascular Health Study Collaborative Research Group: Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci. 2001;3:M146–56.CrossRef Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C, Gottdiener J, Seeman T, Tracy R, Kop WJ, Burke G, McBurnie MA. Cardiovascular Health Study Collaborative Research Group: Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci. 2001;3:M146–56.CrossRef
23.
go back to reference Kahlon S, Pederson J, Majumdar SR, Belga S, Lau D, Fradette M, Boyko D, Bakal JA, Johnston C, Padwal RS, McAlister FA. Association between frailty and 30-day outcomes after discharge from hospital. CMAJ. 2015;187(11):799–804.CrossRefPubMedPubMedCentral Kahlon S, Pederson J, Majumdar SR, Belga S, Lau D, Fradette M, Boyko D, Bakal JA, Johnston C, Padwal RS, McAlister FA. Association between frailty and 30-day outcomes after discharge from hospital. CMAJ. 2015;187(11):799–804.CrossRefPubMedPubMedCentral
24.
go back to reference Danish Health Authority. National clinical guideline for oropharyngeal dysphagia—screening, assessment and selected initiatives. Denmark: The Danish Health Authority; 2015. Danish Health Authority. National clinical guideline for oropharyngeal dysphagia—screening, assessment and selected initiatives. Denmark: The Danish Health Authority; 2015.
25.
go back to reference British Thoracic Society Standards of Care Committee. BTS guidelines for the management of community acquired pneumonia in adults. Thorax. 2001;56:IV1-64.CrossRef British Thoracic Society Standards of Care Committee. BTS guidelines for the management of community acquired pneumonia in adults. Thorax. 2001;56:IV1-64.CrossRef
26.
go back to reference Capelastegui A, Espana PP, Quintana JM, Areitio I, Gorordo I, Egurrola M, Bilbao A. Validation of a predictive rule for the management of community-acquired pneumonia. Eur Respir J. 2006;1:151–7.CrossRef Capelastegui A, Espana PP, Quintana JM, Areitio I, Gorordo I, Egurrola M, Bilbao A. Validation of a predictive rule for the management of community-acquired pneumonia. Eur Respir J. 2006;1:151–7.CrossRef
27.
go back to reference Lim WS, van der Eerden MM, Laing R, Boersma WG, Karalus N, Town GI, Lewis SA, Macfarlane JT. Defining community acquired pneumonia severity on presentation to hospital: an international derivation and validation study. Thorax. 2003;5:377–82.CrossRef Lim WS, van der Eerden MM, Laing R, Boersma WG, Karalus N, Town GI, Lewis SA, Macfarlane JT. Defining community acquired pneumonia severity on presentation to hospital: an international derivation and validation study. Thorax. 2003;5:377–82.CrossRef
28.
go back to reference Charlson ME, Pompei P, Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis. 1987;5:373–83.CrossRef Charlson ME, Pompei P, Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis. 1987;5:373–83.CrossRef
29.
go back to reference Charlson M, Szatrowski TP, Peterson J, Gold J. Validation of a combined comorbidity index. J Clin Epidemiol. 1994;11:1245–51.CrossRef Charlson M, Szatrowski TP, Peterson J, Gold J. Validation of a combined comorbidity index. J Clin Epidemiol. 1994;11:1245–51.CrossRef
30.
go back to reference Schønheyder HC, Myging L. Pneumonia—local guideline. Danish: Region Nordjylland; 2012. Schønheyder HC, Myging L. Pneumonia—local guideline. Danish: Region Nordjylland; 2012.
31.
go back to reference Kristensen MT, Bandholm T, Foss NB, Ekdahl C, Kehlet H. High inter-tester reliability of the new mobility score in patients with hip fracture. J Rehabil Med. 2008;7:589–91.CrossRef Kristensen MT, Bandholm T, Foss NB, Ekdahl C, Kehlet H. High inter-tester reliability of the new mobility score in patients with hip fracture. J Rehabil Med. 2008;7:589–91.CrossRef
32.
go back to reference Collin C, Wade DT, Davies S, Horne V. The Barthel ADL index: a reliability study. Int Disabil Stud. 1988;2:61–3.CrossRef Collin C, Wade DT, Davies S, Horne V. The Barthel ADL index: a reliability study. Int Disabil Stud. 1988;2:61–3.CrossRef
33.
go back to reference Mahoney FI, Barthel DW. Functional evaluation: the Barthel index. Md State Med J. 1965;14:61–5.PubMed Mahoney FI, Barthel DW. Functional evaluation: the Barthel index. Md State Med J. 1965;14:61–5.PubMed
34.
go back to reference Wade DT, Collin C. The Barthel ADL index: a standard measure of physical disability? Int Disabil Stud. 1988;2:64–7.CrossRef Wade DT, Collin C. The Barthel ADL index: a standard measure of physical disability? Int Disabil Stud. 1988;2:64–7.CrossRef
35.
go back to reference Leong DP, Teo KK, Rangarajan S, Lopez-Jaramillo P, Avezum A Jr, Orlandini A, Seron P, Ahmed SH, Rosengren A, Kelishadi R, Rahman O, Swaminathan S, Iqbal R, Gupta R, Lear SA, Oguz A, Yusoff K, Zatonska K, Chifamba J, Igumbor E, Mohan V, Anjana RM, Gu H, Li W, Yusuf S, Prospective Urban rural epidemiology (PURE) Study Investigators. Prognostic value of grip strength: findings from the Prospective Urban rural epidemiology (PURE) study. The Lancet. 2015;386:266–73.CrossRef Leong DP, Teo KK, Rangarajan S, Lopez-Jaramillo P, Avezum A Jr, Orlandini A, Seron P, Ahmed SH, Rosengren A, Kelishadi R, Rahman O, Swaminathan S, Iqbal R, Gupta R, Lear SA, Oguz A, Yusoff K, Zatonska K, Chifamba J, Igumbor E, Mohan V, Anjana RM, Gu H, Li W, Yusuf S, Prospective Urban rural epidemiology (PURE) Study Investigators. Prognostic value of grip strength: findings from the Prospective Urban rural epidemiology (PURE) study. The Lancet. 2015;386:266–73.CrossRef
36.
go back to reference Norman K, Stobaus N, Gonzalez MC, Schulzke JD, Pirlich M. Hand grip strength: outcome predictor and marker of nutritional status. Clin Nutr. 2011;2:135–42.CrossRef Norman K, Stobaus N, Gonzalez MC, Schulzke JD, Pirlich M. Hand grip strength: outcome predictor and marker of nutritional status. Clin Nutr. 2011;2:135–42.CrossRef
37.
go back to reference Clave P, Arreola V, Romea M, Medina L, Palomera E, Serra-Prat M. Accuracy of the volume-viscosity swallow test for clinical screening of oropharyngeal dysphagia and aspiration. Clin Nutr. 2008;6:806–15.CrossRef Clave P, Arreola V, Romea M, Medina L, Palomera E, Serra-Prat M. Accuracy of the volume-viscosity swallow test for clinical screening of oropharyngeal dysphagia and aspiration. Clin Nutr. 2008;6:806–15.CrossRef
38.
go back to reference Collins MJ, Bakheit AM. Does pulse oximetry reliably detect aspiration in dysphagic stroke patients? Stroke. 1997;9:1773–5.CrossRef Collins MJ, Bakheit AM. Does pulse oximetry reliably detect aspiration in dysphagic stroke patients? Stroke. 1997;9:1773–5.CrossRef
39.
go back to reference Rofes L, Arreola V, Mukherjee R, Clave P. Sensitivity and specificity of the Eating Assessment Tool and the Volume-Viscosity Swallow Test for clinical evaluation of oropharyngeal dysphagia. Neurogastroenterol Motil. 2014;9:1256–65.CrossRef Rofes L, Arreola V, Mukherjee R, Clave P. Sensitivity and specificity of the Eating Assessment Tool and the Volume-Viscosity Swallow Test for clinical evaluation of oropharyngeal dysphagia. Neurogastroenterol Motil. 2014;9:1256–65.CrossRef
40.
go back to reference Danish Society of Respiratory Medicine: Assessment and treatment of Community-acquired pneumonia. 2011. Danish Society of Respiratory Medicine: Assessment and treatment of Community-acquired pneumonia. 2011.
41.
go back to reference Zou G. A modified poisson regression approach to prospective studies with binary data. Am J Epidemiol. 2004;7:702–6.CrossRef Zou G. A modified poisson regression approach to prospective studies with binary data. Am J Epidemiol. 2004;7:702–6.CrossRef
42.
go back to reference Bergman H, Ferrucci L, Guralnik J, Hogan DB, Hummel S, Karunananthan S, Wolfson C. Frailty: an emerging research and clinical paradigm–issues and controversies. J Gerontol A Biol Sci Med Sci. 2007;7:731–7.CrossRef Bergman H, Ferrucci L, Guralnik J, Hogan DB, Hummel S, Karunananthan S, Wolfson C. Frailty: an emerging research and clinical paradigm–issues and controversies. J Gerontol A Biol Sci Med Sci. 2007;7:731–7.CrossRef
43.
go back to reference Hansen T, Lambert HC, Faber J. Ingestive skill difficulties are frequent among acutely-hospitalised frail elderly patients, and predict hospital outcomes. Phys Occup Ther Geriatr. 2012;4:271–87.CrossRef Hansen T, Lambert HC, Faber J. Ingestive skill difficulties are frequent among acutely-hospitalised frail elderly patients, and predict hospital outcomes. Phys Occup Ther Geriatr. 2012;4:271–87.CrossRef
44.
go back to reference Cabre M, Serra-Prat M, Palomera E, Almirall J, Pallares R, Clave P. Prevalence and prognostic implications of dysphagia in elderly patients with pneumonia. Age Ageing. 2010;1:39–45.CrossRef Cabre M, Serra-Prat M, Palomera E, Almirall J, Pallares R, Clave P. Prevalence and prognostic implications of dysphagia in elderly patients with pneumonia. Age Ageing. 2010;1:39–45.CrossRef
45.
go back to reference Rudakiewicz J. Methods for managing residents with dysphagia. Nurs Older People. 2015;4:29–33.CrossRef Rudakiewicz J. Methods for managing residents with dysphagia. Nurs Older People. 2015;4:29–33.CrossRef
46.
go back to reference Klausen HH, Petersen J, Lindhardt T, Bandholm T, Hendriksen C, Kehlet H, Vestbo J, Andersen O. Outcomes in elderly Danish citizens admitted with community-acquired pneumonia. Regional differencties, in a public healthcare system. Respir Med. 2012;12:1778–87.CrossRef Klausen HH, Petersen J, Lindhardt T, Bandholm T, Hendriksen C, Kehlet H, Vestbo J, Andersen O. Outcomes in elderly Danish citizens admitted with community-acquired pneumonia. Regional differencties, in a public healthcare system. Respir Med. 2012;12:1778–87.CrossRef
47.
48.
go back to reference Kertscher B, Speyer R, Palmieri M, Plant C. Bedside screening to detect oropharyngeal dysphagia in patients with neurological disorders: an updated systematic review. Dysphagia. 2014;2:204–12.CrossRef Kertscher B, Speyer R, Palmieri M, Plant C. Bedside screening to detect oropharyngeal dysphagia in patients with neurological disorders: an updated systematic review. Dysphagia. 2014;2:204–12.CrossRef
49.
go back to reference Bours GJ, Speyer R, Lemmens J, Limburg M, de Wit R. Bedside screening tests vs. videofluoroscopy or fibre optic endoscopic evaluation of swallowing to detect dysphagia in patients with neurological disorders: systematic review. J Adv Nurs. 2009;3:477–93.CrossRef Bours GJ, Speyer R, Lemmens J, Limburg M, de Wit R. Bedside screening tests vs. videofluoroscopy or fibre optic endoscopic evaluation of swallowing to detect dysphagia in patients with neurological disorders: systematic review. J Adv Nurs. 2009;3:477–93.CrossRef
50.
go back to reference Komiya K, Ishii H, Kadota J. Healthcare-associated pneumonia and aspiration pneumonia. Aging Dis. 2014;1:27–37. Komiya K, Ishii H, Kadota J. Healthcare-associated pneumonia and aspiration pneumonia. Aging Dis. 2014;1:27–37.
51.
go back to reference Marik PE. Aspiration pneumonitis and aspiration pneumonia. N Engl J Med. 2001;9:665–71.CrossRef Marik PE. Aspiration pneumonitis and aspiration pneumonia. N Engl J Med. 2001;9:665–71.CrossRef
52.
go back to reference Sutton JL, Gould RL, Daley S, Coulson MC, Ward EV, Butler AM, Nunn SP, Howard RJ. Psychometric properties of multicomponent tools designed to assess frailty in older adults: a systematic review. BMC Geriatr. 2016;16:55. doi:10.1186/s12877-016-0225-2 Sutton JL, Gould RL, Daley S, Coulson MC, Ward EV, Butler AM, Nunn SP, Howard RJ. Psychometric properties of multicomponent tools designed to assess frailty in older adults: a systematic review. BMC Geriatr. 2016;16:55. doi:10.​1186/​s12877-016-0225-2
53.
go back to reference van Abellan KG, Rolland Y, Bergman H, Morley JE, Kritchevsky SB, Vellas B. The I.A.N.A Task Force on frailty assessment of older people in clinical practice. J Nutr Health Aging 2008;1:29–37. van Abellan KG, Rolland Y, Bergman H, Morley JE, Kritchevsky SB, Vellas B. The I.A.N.A Task Force on frailty assessment of older people in clinical practice. J Nutr Health Aging 2008;1:29–37.
54.
go back to reference Smets IH, Kempen GI, Janssen-Heijnen ML, Deckx L, Buntinx FJ, van den Akker M. Four screening instruments for frailty in older patients with and without cancer: a diagnostic study. BMC Geriatr. 2014;14:16. doi:10.1186/1471-2318-14-26. Smets IH, Kempen GI, Janssen-Heijnen ML, Deckx L, Buntinx FJ, van den Akker M. Four screening instruments for frailty in older patients with and without cancer: a diagnostic study. BMC Geriatr. 2014;14:16. doi:10.​1186/​1471-2318-14-26.
Metadata
Title
The Prevalence of Oropharyngeal Dysphagia in Danish Patients Hospitalised with Community-Acquired Pneumonia
Authors
Dorte Melgaard
Ulrik Baandrup
Martin Bøgsted
Mette Dahl Bendtsen
Tina Hansen
Publication date
01-06-2017
Publisher
Springer US
Published in
Dysphagia / Issue 3/2017
Print ISSN: 0179-051X
Electronic ISSN: 1432-0460
DOI
https://doi.org/10.1007/s00455-016-9765-z

Other articles of this Issue 3/2017

Dysphagia 3/2017 Go to the issue