Abstract
Objectives: To examine the predictors of prolonged dysphagia at discharge in cardiovascular patients treated with invasive and non-invasive mechanical ventilation (MV).
Methods: Inpatients with dysphagia and cardiovascular disease treated with MV at Japanese Red Cross Ashikaga Hospital were evaluated between April 2019 and August 2022 in this retrospective observational study. Age, sex, ambulatory ability, Geriatric Nutritional Risk Index (GNRI), primary heart disease, Charlson Comorbidity Index, invasive or non-invasive MV, Sequential Organ Failure Assessment, duration of MV, days from the withdrawal of MV to the start of rehabilitation, Functional Oral Intake Scale (FOIS) at the start of rehabilitation and at discharge, length of hospital stay, training time per day, pneumonia after the start of rehabilitation, and death during hospitalization were surveyed. To assess the predictors of death and dysphagia at discharge, univariate comparisons and Firth's logistic regression analyses were performed.
Results: Ten of the 128 patients died, and 71 patients had dysphagia at discharge. Lower FOIS scores (P = 0.04), less training time per day (P < 0.01), and pneumonia (P = 0.02) were significantly associated with death in univariate comparisons. Ambulatory ability (odds ratio = 0.09; 95% confidence interval = 0.01-1.48, P = 0.04) and the nutritional risk assessed by GNRI (odds ratio = 1.84; 95% confidence interval = 1.20-2.81, P < 0.01) were the independent predictors of dysphagia at discharge in Firth's logistic regression analysis.
Conclusions: Ambulatory ability and GNRI are valuable as the predictors of prolonged dysphagia at discharge in cardiovascular patients treated with MV.
