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Survival estimates for patients with abnormal swallowing studies
M E Cowen1, S L Simpson, T E Vettese
1St. Joseph Mercy Hospital, Ann Arbor, Mich 48106, USA.
Journal of General Internal Medicine
|February 1, 1997
Summary
Patients with abnormal swallowing studies face high mortality, with 62% dying within one year. Advanced age and comorbidity scores predict poor prognosis, informing decisions about feeding tube placement.
Area of Science:
- Clinical Medicine
- Gerontology
- Gastroenterology
Background:
- Abnormal videofluoroscopic swallowing studies (VFSS) indicate significant dysphagia.
- Understanding prognosis in these patients is crucial for clinical decision-making.
Purpose of the Study:
- To determine the life expectancy of patients with abnormal VFSS.
- To identify prognostic factors for mortality in this population.
Main Methods:
- Retrospective cohort study of 149 hospitalized patients with abnormal VFSS.
- Review of clinical and demographic variables, blinded to survival outcomes.
- Survival time was analyzed using multivariable Cox proportional hazards models.
Main Results:
- One-year mortality was 62%.
- Independent predictors of death included advanced age, low serum albumin, disorientation, and high Charlson comorbidity score.
- 54% of patients received a percutaneous endoscopic gastrostomy (PEG) tube post-study.
Conclusions:
- High mortality rates are observed in patients with severely abnormal swallowing studies.
- Clinical variables effectively identify high-risk patient groups.
- Prognostic information aids in discussions regarding PEG tube placement.