Preoperative dysphagia risk in community-dwelling adults aged ≥50 years: Prevalence and risk factors.
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2023-02
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Abstract
Background
Preoperative dysphagia screening is rare. The purpose of this study was to assess the prevalence and potential risk factors of preoperative dysphagia risk in adults preparing for surgery.Methods
The Eating Assessment Tool (EAT-10), Patient-Generated Subjective Global Assessment Short Form (PG-SGA SF), and Sarcopenia Screening Tool (SARC-F) were self-administered in adults preparing for surgery to identify dysphagia, malnutrition, and sarcopenia risk, respectively. Other variables collected include clinical demographics, fall risk, and surgical history associated with increased dysphagia risk. Descriptive summary statistics, univariate analysis, and logistic regression were performed as appropriate.Results
The median age was 69 years and preoperative dysphagia risk was 9.6%. Among 357 patients completing both EAT-10 and PG-SGA SF or SARC-F, 7.3% had preoperative dysphagia and malnutrition risk and 7.2% had preoperative dysphagia and sarcopenia risk. Preoperative dysphagia risk was 2.7 times greater in those with prior surgical history associated with increased risk of dysphagia, 2.2 times higher in women, and almost twice as high in Black patients and patients with fall risk. Logistic regression revealed significant odds ratios (ORs) for prior surgical history associated with increased risk of dysphagia (OR, 2.95; 95% CI, 1.62-5.40) and male sex (OR, 0.52; 95% CI, 0.29-0.94), and a significant relationship between preoperative dysphagia and malnutrition risk (OR, 4.56; 95% CI, 2.02-10.28) when controlling for clinical variables.Conclusion
The high prevalence of dysphagia risk alone and in combination with malnutrition and sarcopenia risk in community-dwelling adults underscores the need for standardized preoperative screening and optimization prior to surgery.Type
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Canick, Julia, James C Campbell, Seth M Cohen, Harrison N Jones, David A Leiman, Sudha Raman and Kathryn N Porter Starr (2023). Preoperative dysphagia risk in community-dwelling adults aged ≥50 years: Prevalence and risk factors. Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition, 38(1). pp. 157–166. 10.1002/ncp.10889 Retrieved from https://hdl.handle.net/10161/27290.
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Scholars@Duke
Seth Morris Cohen
Dr. Cohen is an otolaryngologist head & neck surgeon with fellowship training in laryngology. He performs clinical care and research focused on patients with voice, airway, and swallowing problems.
Harrison N. Jones
David Asher Leiman
Dr. Leiman is an Associate Professor of Medicine and gastroenterologist specializing in esophageal diseases and swallowing disorders, such as eosinophilic esophagitis (EoE), motility disorders such as achalasia, and gastroesophageal reflux disease (GERD) as well as its associated complications including Barrett’s esophagus (BE). His busy clinical practice dovetails with his academic focus on health services research, including patient outcomes and clinical quality measurement. He is also a PI for several ongoing multicenter clinical trials investigating novel therapies for EoE and GERD.
Dr. Leiman has mentored numerous medical students, residents, and GI fellows on research and quality improvement projects resulting in research awards, presentations at national meetings, and peer-reviewed publications.
Sudha Rani Raman
Areas of expertise: Epidemiology and Health Services Research
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