Early Clinical Swallow Evaluation Is Associated with Lower Malnutrition Prevalence at Discharge in Neurogeriatric...

Malnutrition is a known outcome of dysphagia.

To estimate the association between the timing of the Clinical Swallow Evaluation (CSE) at admission and nutrition status at hospital discharge.

In this single-center prospective study, the electronic medical records of patients discharged from the neurogeriatric rehabilitation department at the participating hospital, who had undergone CSE by a speech pathologist per hospital bed-side evaluation protocol, were reviewed. The participants were divided into two groups: those who underwent CSE within 48 h of hospitalization per Israel Ministry of Health guidelines (early CSE, N = 31); and those who underwent CSE later than 48 h from admission (late CSE, N = 47). Nutrition status was evaluated by a registered dietitian using the Mini Nutritional Assessment Tool Short Form (MNA-SF). Nutrition status at discharge was categorized and compared between the groups.

Seventy-eight patients were included (mean age 80.7 ± 8.1 years); 85.9% were malnourished at admission, with no difference between groups. At discharge, malnutrition was less prevalent in the early vs. late CSE group (61.3% vs. 78.7%; p = 0.012). In multivariable logistic regression, late CSE increased odds of malnutrition at discharge by more than six-fold. Each additional year of age increased the odds of malnutrition by 13%; each additional point in baseline MNA SF score reduced the odds by 48%; and greater cognitive decline increased the odds of discharge malnutrition risk by more than 2.6-fold. Sex and the number of dietitian consultations were not associated with malnutrition at discharge.

Early CSE in elderly patients hospitalized for neurogeriatric rehabilitation is associated with less malnutrition at discharge.