Postextubation Dysphagia in Critical Patients: A First Report From the Largest Step-Down Intensive Care Unit in Greece Purpose This study provided preliminary data on the occurrence and impact of postextubation dysphagia in the largest Greek step-down intensive care unit (ICU) over 2 years. Method A retrospective observational cohort study of patients referred for swallowing assessment postextubation was conducted from November, 2011, to August, 2013. ... Clinical Forum
Clinical Forum  |   May 01, 2016
Postextubation Dysphagia in Critical Patients: A First Report From the Largest Step-Down Intensive Care Unit in Greece
 
Author Affiliations & Notes
  • Georgia A. Malandraki
    Teachers College, Columbia University, New York, NY
    Hospital Evangelismos, Athens, Greece
    Athens Medical School, National and Kapodistrian University of Athens, Greece
  • Vasiliki Markaki
    Hospital Evangelismos, Athens, Greece
  • Voula C. Georgopoulos
    Technological Educational Institute of Western Greece, Patras, Greece
  • Loukia Psychogios
    Hospital Evangelismos, Athens, Greece
  • Serafim Nanas
    Athens Medical School, National and Kapodistrian University of Athens, Greece
  • Disclosure: The authors have declared that no competing interests existed at the time of publication.
    Disclosure: The authors have declared that no competing interests existed at the time of publication. ×
  • Correspondence to Georgia A. Malandraki, who is now at Purdue University: malandraki@purdue.edu
  • Editor: Krista Wilkinson
    Editor: Krista Wilkinson×
  • Associate Editor: Katherine Verdolini Abbott
    Associate Editor: Katherine Verdolini Abbott×
Article Information
Swallowing, Dysphagia & Feeding Disorders / Clinical Forum: Record Reviews
Clinical Forum   |   May 01, 2016
Postextubation Dysphagia in Critical Patients: A First Report From the Largest Step-Down Intensive Care Unit in Greece
American Journal of Speech-Language Pathology, May 2016, Vol. 25, 150-156. doi:10.1044/2015_AJSLP-14-0069
History: Received May 18, 2014 , Revised September 25, 2014 , Accepted July 3, 2015
 
American Journal of Speech-Language Pathology, May 2016, Vol. 25, 150-156. doi:10.1044/2015_AJSLP-14-0069
History: Received May 18, 2014; Revised September 25, 2014; Accepted July 3, 2015

Purpose This study provided preliminary data on the occurrence and impact of postextubation dysphagia in the largest Greek step-down intensive care unit (ICU) over 2 years.

Method A retrospective observational cohort study of patients referred for swallowing assessment postextubation was conducted from November, 2011, to August, 2013.

Results Of the 357 patients admitted to the unit during this period, 87, aged 55.8 ± 18.1 years (61 male, 26 female), were referred and evaluated. Of these, 2.3% were found to have no dysphagia, and 21.8% and 75.9% were diagnosed with mild and moderate/severe dysphagia, respectively. Across severity levels, 23% of patients in the unit were found to have dysphagia. Patients with moderate/severe dysphagia were more likely to have had prolonged intubation (> 48 hr; p = .02) and exhibit signs of aspiration (p = .002) than those with no or mild dysphagia. Prolonged intubation was associated with increased likelihood of moderate/severe dysphagia by a factor of 12 (p = .042, odds ratio = 12.355) compared to short intubation. Moderate/severe dysphagia was correlated with pneumonia (p = .02), feeding tube placement (p = .004) and in-hospital mortality (p = .034).

Conclusion In this sample, moderate/severe dysphagia was correlated with prolonged intubation, and was found to increase the risk for pneumonia and in-hospital mortality. Our results suggest the importance of early dysphagia management in critical patients in Greece and globally.

Acknowledgment
This work was partially funded by a seed fund awarded to the first author by Teachers College, Columbia University, New York, NY.
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