Researchers from Mount Sinai School of Medicine have found that hospitalized patients with dysphagia, or difficulty swallowing, averaged a 40 percent longer hospital stay than patients without the condition. They also had a generally poorer prognosis. The research is published in the August issue of Archives of Otolaryngology-Head & Neck Surgery, one of the JAMA/Archives journals.
The researchers evaluated more than 77 million hospital admissions during 2005-2006, 271,983 of which were associated with dysphagia, as indicated by the National Hospital Discharge Survey (NHDS). The median number of days in the hospital for patients with dysphagia was 4.04, compared to 2.40 days for patients without dysphagia. Mortality increased significantly in patients with dysphagia and disk disorders or heart disease, and those undergoing rehabilitation had a greater than 13-fold increased risk of mortality. Patients ages 75 and older were twice as likely to have dysphagia.
"Our study shows that dysphagia has a significant impact on length of stay and prognostic indicators," said Kenneth W. Altman, MD, PhD, Associate Professor of Otolaryngology, lead author on the study. "Early identification of dysphagia and therapeutic intervention are critical to preventing further complications in these patients and reducing length of stay. These data indicate the necessity for health care providers to prevent or diagnose this condition early to reduce complications."
The impact of dysphagia on hospital resources was also substantial. Patients with dysphagia are often at risk of aspirating, which often requires antibiotic use and intubation. The increased mortality risk associated with the condition also increases end-of-life costs. Using a measurement tool previously developed for community-acquired pneumonia, the researchers estimated the cost of dysphagia at nearly $550 million over the two year period.