Dysphagia among geriatric trauma patients: A population-based study.

Area of Science:

• Geriatric Trauma Care
• Clinical Outcomes Research
• Swallowing Disorders

Background:

• Geriatric trauma patients are at high risk for developing dysphagia post-admission.
• Dysphagia in this population is often linked to severe injuries like traumatic brain and cervical spine injuries.
• Pre-existing dysphagia was excluded to focus on incident cases.

Purpose of the Study:

• To investigate the impact of post-traumatic dysphagia on mortality, length of stay, and complications in geriatric trauma patients.
• To identify risk factors associated with the development of dysphagia in this cohort.
• To evaluate the effect of interventions like mechanical ventilation and feeding tubes on outcomes.

Main Methods:

• Retrospective analysis of a large population-based dataset (Florida AHCA, 2010-2019).
• Inclusion of geriatric trauma patients (≥65 years) without pre-admission dysphagia.
• Multivariable regression used for statistical adjustments and outcome analysis.

Main Results:

• Over 52,000 geriatric trauma patients developed dysphagia, associated with increased mortality, longer stays, and more complications.
• Mechanical ventilation, particularly when combined with transgastric feeding tubes (GFTs), was linked to decreased mortality.
• Tracheostomy placement emerged as an independent risk factor for dysphagia development.

Conclusions:

• Geriatric trauma patients are highly susceptible to dysphagia, especially those with TBI, cervical spine injuries, and polytrauma requiring mechanical ventilation.
• Early mechanical ventilation and GFTs may reduce inpatient mortality.
• Speech-language pathology services were inconsistently utilized, suggesting a need for improved integration.