Is Dysphagia After Cardiac Operations a "Preexisting Condition"?

Area of Science:

• Cardiology
• Neurology
• Gastroenterology

Background:

• Dysphagia incidence post-cardiac surgery is debated.
• Baseline dysphagia risk in cardiac patients is largely unknown.
• This study assesses pre- and post-operative dysphagia in cardiac surgery patients.

Purpose of the Study:

• To determine the incidence of dysphagia before and after cardiac operations.
• To identify risk factors associated with dysphagia in this patient population.

Main Methods:

• 176 patients undergoing cardiac surgery were screened for dysphagia.
• Screening included a water swallow challenge, cognitive/speech screen, and oral mechanism screen.
• Tests were repeated post-extubation in alert patients; characteristics were analyzed for risk factors.

Main Results:

• 15 patients (8.5%) had pre-operative dysphagia, associated with older age and chronic renal failure.
• Post-operatively, 38 patients (21.6%) failed the swallow screen, with older age being a significant factor.
• All patients with pre-operative dysphagia also failed the post-operative screen.

Conclusions:

• Undiagnosed dysphagia is prevalent pre-operatively in cardiac surgery candidates.
• This pre-existing dysphagia contributes significantly to post-operative swallowing difficulties.
• Older age is a risk factor, but gender and other comorbidities do not reliably predict dysphagia risk.