Occurrence of Dysphagia in Patients Admitted to a Department of Pulmonary Medicine

Awareness of dysphagia and its clinical implications is increasing, yet its occurrence and impact among patients in Departments of Pulmonary Medicine remain underexplored. This study aims to assess the occurrence of dysphagia using standardized screening tools and describe the findings across patient subgroups.

Over six months, patients aged 65 or older-or those under 65 with dysphagia risk factors-admitted to the Department of Pulmonary Medicine were screened using the Four-Question Test (4QT) and a 30 mL water swallow test. Those who screened positive were referred to a full clinical swallow assessment.

Of the 945 patients admitted to the Departments of Pulmonary Medicine, 800 met the inclusion criteria, and 679 were screened for dysphagia. Screening was incomplete for 121 patients due to early discharge, time constraints, or limited project awareness during the initial phase. Overall, 160 patients (17%) screened positive for dysphagia risk and were referred for further swallow assessment. Among these, 74 (46%) had previously been diagnosed with dysphagia. Ultimately, 118 patients underwent further assessment, with dysphagia confirmed in 111 (94%). A positive screening test was identified in 21% of patients admitted with pulmonary diseases. In comparison, 32% of patients admitted with other medical conditions, including those with a working or admission diagnosis of cardiovascular disease, non-pulmonary infections, or cancer, screened positive.

Dysphagia is common yet underdiagnosed in Departments of Pulmonary Medicine, regardless of the admission diagnosis. This study demonstrates that simple bedside screening can effectively identify patients at risk of dysphagia. Systematic screening at admission may enable earlier detection and intervention for dysphagia in a hospital setting.