Postextubation Dysphagia in Critical Patients: A First Report From the Largest Step-Down Intensive Care Unit in...

This study provided preliminary data on the occurrence and impact of postextubation dysphagia in the largest Greek step-down intensive care unit (ICU) over 2 years.

A retrospective observational cohort study of patients referred for swallowing assessment postextubation was conducted from November, 2011, to August, 2013.

Of the 357 patients admitted to the unit during this period, 87, aged 55.8 ± 18.1 years (61 male, 26 female), were referred and evaluated. Of these, 2.3% were found to have no dysphagia, and 21.8% and 75.9% were diagnosed with mild and moderate/severe dysphagia, respectively. Across severity levels, 23% of patients in the unit were found to have dysphagia. Patients with moderate/severe dysphagia were more likely to have had prolonged intubation (> 48 hr; p = .02) and exhibit signs of aspiration (p = .002) than those with no or mild dysphagia. Prolonged intubation was associated with increased likelihood of moderate/severe dysphagia by a factor of 12 (p = .042, odds ratio = 12.355) compared to short intubation. Moderate/severe dysphagia was correlated with pneumonia (p = .02), feeding tube placement (p = .004) and in-hospital mortality (p = .034).

In this sample, moderate/severe dysphagia was correlated with prolonged intubation, and was found to increase the risk for pneumonia and in-hospital mortality. Our results suggest the importance of early dysphagia management in critical patients in Greece and globally.