Prevalence and predictors of dysphagia in cardiac patients during intensive rehabilitation: a cross-sectional study.
This study aimed to investigate the prevalence of dysphagia in cardiac patients admitted to intensive rehabilitation following cardiac surgery or interventional procedures and to identify associated clinical and demographic risk factors.
A retrospective observational study was conducted on 93 patients consecutively admitted to a cardiac intensive rehabilitation unit between March and April 2023. Swallowing function was assessed using the Gugging Swallowing Screen (GUSS), Mealtime Assessment Scale (MAS), and the Italian Dysphagia Handicap Index (I-DHI). The impact of these scales on the American Speech-Language-Hearing Association National Outcome Measurement System (ASHA-NOMS) scale was assessed. Logistic regression identified predictors of dysphagia.
Dysphagia (ASHA-NOMS ≤6) was identified in 33.3% of patients. Dysphagic patients were older (median 73 vs. 67.5 years, p = 0.001) and had a higher prevalence of prior intubation (93.6% vs. 75.8%, p = 0.037). Intubation (OR = 6.33, p = 0.033) and age (OR = 1.08, p = 0.012) were independent predictors of dysphagia. The MAS safety subscale showed the highest correlation with dysphagia severity (r=-0.93).
Dysphagia is common in patients with cardiovascular disease admitted to the intensive cardiac rehabilitation, regardless of surgical history. Early identification of dysphagia and timely intervention within a multidisciplinary rehabilitation framework are essential to prevent complications and optimize functional recovery in cardiac patients.
A retrospective observational study was conducted on 93 patients consecutively admitted to a cardiac intensive rehabilitation unit between March and April 2023. Swallowing function was assessed using the Gugging Swallowing Screen (GUSS), Mealtime Assessment Scale (MAS), and the Italian Dysphagia Handicap Index (I-DHI). The impact of these scales on the American Speech-Language-Hearing Association National Outcome Measurement System (ASHA-NOMS) scale was assessed. Logistic regression identified predictors of dysphagia.
Dysphagia (ASHA-NOMS ≤6) was identified in 33.3% of patients. Dysphagic patients were older (median 73 vs. 67.5 years, p = 0.001) and had a higher prevalence of prior intubation (93.6% vs. 75.8%, p = 0.037). Intubation (OR = 6.33, p = 0.033) and age (OR = 1.08, p = 0.012) were independent predictors of dysphagia. The MAS safety subscale showed the highest correlation with dysphagia severity (r=-0.93).
Dysphagia is common in patients with cardiovascular disease admitted to the intensive cardiac rehabilitation, regardless of surgical history. Early identification of dysphagia and timely intervention within a multidisciplinary rehabilitation framework are essential to prevent complications and optimize functional recovery in cardiac patients.
Authors
Stilo Stilo, Antolini Antolini, Volpato Volpato, Patrignani Patrignani, Gualandris Gualandris, Bordoni Bordoni, Toccafondi Toccafondi, Barbone Barbone, Torracca Torracca, Novembre Novembre, Morici Morici
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