Prevalence and Risk Factors of Dysphagia in Amyotrophic Lateral Sclerosis: A Retrospective Study Using the Nationwide...

Area of Science:

• Neurology
• Gastroenterology
• Public Health

Background:

• Dysphagia is a significant complication in Amyotrophic Lateral Sclerosis (ALS), impacting patient morbidity and healthcare resource utilization.
• The prevalence, risk factors, and clinical outcomes associated with dysphagia in hospitalized ALS patients remain under-characterized.

Purpose of the Study:

• To determine the prevalence of dysphagia in hospitalized ALS patients.
• To identify independent risk factors associated with dysphagia development in ALS.
• To assess the adverse clinical outcomes and healthcare utilization linked to dysphagia in ALS.

Main Methods:

• A retrospective cohort study utilizing the Nationwide Inpatient Sample (NIS) database from 2010-2019.
• Analysis of 23,997 hospitalized ALS cases, examining demographics, comorbidities, hospital characteristics, and clinical outcomes.
• Multivariate analysis to identify independent risk factors and associated complications.

Main Results:

• Dysphagia was diagnosed in 31.7% (7419/23,997) of hospitalized ALS patients.
• Patients with dysphagia had longer hospital stays (5 vs. 4 days) and incurred higher costs (+$6656).
• Independent risk factors included older age, female sex, Hispanic ethnicity, specific hospital types, and comorbidities like malnutrition and depression. Complications included cognitive impairment, stroke, respiratory paralysis, and tracheostomy.

Conclusions:

• Dysphagia is prevalent in approximately one-third of hospitalized ALS patients, significantly increasing hospital stay duration and costs.
• Key risk factors identified highlight specific patient demographics and comorbidities.
• Emphasizes the need for timely dysphagia screening and targeted interventions in ALS care to mitigate complications and optimize resource allocation.