Dysphagia in adult intensive care patients: Results of a prospective, multicentre binational point prevalence study.

Freeman-Sanderson, A; Hemsley, B; Thompson, K; Rogers, KD; Knowles, S; Hammond, NE; George Institute for Global Health and the Australian and New Zealand Intensive Care Society Clinical Trials Group,

Dysphagia in adult intensive care patients: Results of a prospective, multicentre binational point prevalence study.

Thompson, K Rogers, KD Knowles, S Hammond, NE George Institute for Global Health and the Australian and New Zealand Intensive Care Society Clinical Trials Group,

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Publisher:: ELSEVIER SCIENCE INC
Publication Type:: Journal Article
Citation:: Aust Crit Care, 2023, 36, (6), pp. 961-966
Issue Date:: 2023-11

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Field	Value	Language
dc.contributor.author	Freeman-Sanderson, A https://orcid.org/0000-0003-2161-6421
dc.contributor.author	Hemsley, B https://orcid.org/0000-0002-6255-3140
dc.contributor.author	Thompson, K
dc.contributor.author	Rogers, KD
dc.contributor.author	Knowles, S
dc.contributor.author	Hammond, NE
dc.contributor.author	George Institute for Global Health and the Australian and New Zealand Intensive Care Society Clinical Trials Group,
dc.date.accessioned	2024-01-04T04:04:51Z
dc.date.available	2023-01-08
dc.date.available	2024-01-04T04:04:51Z
dc.date.issued	2023-11
dc.identifier.citation	Aust Crit Care, 2023, 36, (6), pp. 961-966
dc.identifier.issn	1036-7314
dc.identifier.issn	1878-1721
dc.identifier.uri	http://hdl.handle.net/10453/173996
dc.description.abstract	BACKGROUND: Dysphagia occurs in intensive care unit (ICU) patients. However, there is a lack of epidemiological data on the prevalence of dysphagia in adult ICU patients. OBJECTIVES: The objective of this study was to describe the prevalence of dysphagia in nonintubated adult patients in the ICU. METHODS: A prospective, multicentre, binational, cross-sectional point prevalence study was conducted in 44 adult ICUs in Australia and New Zealand. Data were collected in June 2019 on documentation of dysphagia, oral intake, and ICU guidelines and training. Descriptive statistics were used to report demographic, admission, and swallowing data. Continuous variables are reported as means and standard deviations (SDs). Precisions of estimates were reported as 95% confidence intervals (CIs). RESULTS: Of the 451 eligible participants, 36 (7.9%) were documented as having dysphagia on the study day. In the dysphagia cohort, the mean age was 60.3 years (SD: 16.37) vs 59.6 years (SD: 17.1) and almost two-thirds were female (61.1% vs 40.1%). The most common admission source for those patients with dysphagia were from the emergency department (14/36, 38.9%), and seven of 36 (19.4%) had a primary diagnosis of trauma (odds ratio: 3.10, 95% CI 1.25 - 7.66). There were no statistical differences in Acute Physiology and Chronic Health Evaluation (APACHE II) scores between those with and without a dysphagia diagnosis. Patients with dysphagia were more likely to have a lower mean body weight of 73.3 kg vs 82.1 kg than patients not documented as having dysphagia (95% CI of mean difference: 0.43 to 17.07) and require respiratory support (odds ratio: 2.12, 95% 1.06 to 4.25). The majority of patients with dysphagia were prescribed modified food and fluids in the ICU. Less than half of ICUs surveyed reported unit-level guidelines, resources, or training for management of dysphagia. CONCLUSIONS: The prevalence of documented dysphagia in adult ICU nonintubated patients was 7.9%. There were a higher proportion of females with dysphagia than previously reported. Approximately two-thirds of patients with dysphagia were prescribed oral intake, and the majority were receiving texture-modified food and fluids. Dysphagia management protocols, resources, and training are lacking across Australian and New Zealand ICUs.
dc.format	Print-Electronic
dc.language	eng
dc.publisher	ELSEVIER SCIENCE INC
dc.relation.ispartof	Aust Crit Care
dc.relation.isbasedon	10.1016/j.aucc.2023.01.004
dc.rights	info:eu-repo/semantics/closedAccess
dc.subject	1103 Clinical Sciences, 1110 Nursing
dc.subject.classification	Nursing
dc.subject.classification	4205 Nursing
dc.subject.mesh	Adult
dc.subject.mesh	Female
dc.subject.mesh	Humans
dc.subject.mesh	Male
dc.subject.mesh	Middle Aged
dc.subject.mesh	Australia
dc.subject.mesh	Critical Care
dc.subject.mesh	Cross-Sectional Studies
dc.subject.mesh	Deglutition Disorders
dc.subject.mesh	Intensive Care Units
dc.subject.mesh	Prevalence
dc.subject.mesh	Prospective Studies
dc.subject.mesh	Aged
dc.subject.mesh	Humans
dc.subject.mesh	Deglutition Disorders
dc.subject.mesh	Critical Care
dc.subject.mesh	Prevalence
dc.subject.mesh	Prospective Studies
dc.subject.mesh	Cross-Sectional Studies
dc.subject.mesh	Adult
dc.subject.mesh	Aged
dc.subject.mesh	Middle Aged
dc.subject.mesh	Intensive Care Units
dc.subject.mesh	Australia
dc.subject.mesh	Female
dc.subject.mesh	Male
dc.subject.mesh	Humans
dc.subject.mesh	Adult
dc.subject.mesh	Female
dc.subject.mesh	Middle Aged
dc.subject.mesh	Male
dc.subject.mesh	Prevalence
dc.subject.mesh	Prospective Studies
dc.subject.mesh	Deglutition Disorders
dc.subject.mesh	Cross-Sectional Studies
dc.subject.mesh	Australia
dc.subject.mesh	Critical Care
dc.subject.mesh	Intensive Care Units
dc.title	Dysphagia in adult intensive care patients: Results of a prospective, multicentre binational point prevalence study.
dc.type	Journal Article
utslib.citation.volume	36
utslib.location.activity	Australia
utslib.for	1103 Clinical Sciences
utslib.for	1110 Nursing
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/Graduate School of Health
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/Graduate School of Health/GSH.Speech Pathology
utslib.copyright.status	closed_access	*
dc.date.updated	2024-01-04T04:04:50Z
pubs.issue	6
pubs.publication-status	Published
pubs.volume	36
utslib.citation.issue	6

Abstract:

BACKGROUND: Dysphagia occurs in intensive care unit (ICU) patients. However, there is a lack of epidemiological data on the prevalence of dysphagia in adult ICU patients. OBJECTIVES: The objective of this study was to describe the prevalence of dysphagia in nonintubated adult patients in the ICU. METHODS: A prospective, multicentre, binational, cross-sectional point prevalence study was conducted in 44 adult ICUs in Australia and New Zealand. Data were collected in June 2019 on documentation of dysphagia, oral intake, and ICU guidelines and training. Descriptive statistics were used to report demographic, admission, and swallowing data. Continuous variables are reported as means and standard deviations (SDs). Precisions of estimates were reported as 95% confidence intervals (CIs). RESULTS: Of the 451 eligible participants, 36 (7.9%) were documented as having dysphagia on the study day. In the dysphagia cohort, the mean age was 60.3 years (SD: 16.37) vs 59.6 years (SD: 17.1) and almost two-thirds were female (61.1% vs 40.1%). The most common admission source for those patients with dysphagia were from the emergency department (14/36, 38.9%), and seven of 36 (19.4%) had a primary diagnosis of trauma (odds ratio: 3.10, 95% CI 1.25 - 7.66). There were no statistical differences in Acute Physiology and Chronic Health Evaluation (APACHE II) scores between those with and without a dysphagia diagnosis. Patients with dysphagia were more likely to have a lower mean body weight of 73.3 kg vs 82.1 kg than patients not documented as having dysphagia (95% CI of mean difference: 0.43 to 17.07) and require respiratory support (odds ratio: 2.12, 95% 1.06 to 4.25). The majority of patients with dysphagia were prescribed modified food and fluids in the ICU. Less than half of ICUs surveyed reported unit-level guidelines, resources, or training for management of dysphagia. CONCLUSIONS: The prevalence of documented dysphagia in adult ICU nonintubated patients was 7.9%. There were a higher proportion of females with dysphagia than previously reported. Approximately two-thirds of patients with dysphagia were prescribed oral intake, and the majority were receiving texture-modified food and fluids. Dysphagia management protocols, resources, and training are lacking across Australian and New Zealand ICUs.

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http://hdl.handle.net/10453/173996