Abstract
Objectives
To evaluate the patterns of dysphagia, aspiration, and vocal cord motion abnormality (VCMA) among inpatients at a tertiary care referral hospital.
Methods
The medical records of all patients undergoing fiberoptic endoscopic evaluation of swallowing (FEES) between July 2005 and June 2007 were reviewed retrospectively. Demographic information, and presence of aspiration or VCMA was documented. Patients were categorized according to indication for hospitalization as well as into surgical and non-surgical categories. Dysphagia severity was assessed and variations in the prevalence of aspiration and VCMA were ascertained using correlation analysis.
Results
418 inpatients underwent FEES. Commonly observed patient categories included: 1) neurological/neurosurgical, 2) liver disease/transplant, 3) cardiac surgery, 4) medicine, 5) other surgical. The overall prevalence of aspiration and VCMA were 51% and 21% respectively. VCMA was observed twice as frequently in surgical patients (p = 0.0005), while aspiration was seen at similar rates (p = 0.85) among surgical and non-surgical patients. Dysphagia was most severe in neurological/neurosurgical patients. The prevalence of VCMA was highest in cardiac surgery patients (p = 0.007), but the incidence of aspiration did not differ markedly among the groups (p = 0.18).
Conclusions
Swallowing dysfunction is associated with a multitude of medical and surgical conditions. The severity of dysphagia, and the prevalence of associated VCMA vary among different patient categories, while aspiration occurs at similar rates. Understanding these patterns is crucial in guiding the diagnosis and management of inpatients with dysphagia.
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