Clinical, Patient And Service Outcomes For Patients In A Rehabilitation Hospital With An Onsite Flexible Endoscopic Evaluation Of Swallowing Service

IF 6 2区 医学 Q1 GERIATRICS & GERONTOLOGY Age and ageing Pub Date : 2024-09-30 DOI:10.1093/ageing/afae178.333
Kara Flaherty, Aideen Lawlor, Laura Douglas
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Abstract

Background Dysphagia has been reported in almost half of hospital patients who are over 65 years.1 In 2023 a Flexible Endoscopic Evaluation of Swallowing (FEES) service was introduced into the hospital. The purpose of this study was to profile the patients who were referred for FEES and determine the prevalence and severity of dysphagia. Methods Information on patient diagnosis, dysphagia related clinical outcome measures and waiting times when compared to Videofluoroscopy referral were collected from 30 patients who attended for FEES assessment in a rehabilitation hospital from August 2023 - May 2024. Results 97% of the patients who engaged in FEES were above the age of 65. Patients presented with a range of diagnoses including frailty (20%), progressive neurological conditions (18%), other (16.6%), stroke (13.3%), Chronic Obstructive Pulmonary Disease (13.3%), Acquired Brain Injury (3%), Gastroenterology (3%), and surgical (3%). Dysphagia was identified in 97% of patients, with 60% presenting within the moderate to severe range on the Australian Therapy Outcome Measures. 33% of patients presented with silent aspiration, with a third of these patients presenting as clinically asymptomatic. Following FEES evaluation, 40% of patients were recommended a change in diet texture or fluid consistency, with 54% and 70% of these patients being recommended a downgrade in diet or fluids respectively. The service has allowed for more timely access to instrumental swallow assessment with completion of FEES within an average of 4 days compared to referral for Videofluoroscopy; 24 days average. Conclusion This study has enabled us to profile patients accessing FEES. FEES facilitates quicker access to instrumental swallow assessment and identification of aspiration. It has also enabled targeted person centered dysphagia rehab. Reference 1. Doan, T.N et al (2022) Prevalence and methods for assessment of oropharyngeal dysphagia in older adults: a systematic review and meta-analysis. Journal of Clinical Medicine, 11(9), p.2605.
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一家提供现场灵活内窥镜吞咽评估服务的康复医院的临床、患者和服务成果
背景 据报道,几乎半数 65 岁以上的医院患者都有吞咽困难1。2023 年,医院引入了灵活内窥镜吞咽评估(FEES)服务。本研究的目的是对转诊至 FEES 的患者进行分析,并确定吞咽困难的发生率和严重程度。方法 收集 2023 年 8 月至 2024 年 5 月期间在一家康复医院接受 FEES 评估的 30 名患者的信息,包括患者诊断、吞咽困难相关临床结果测量以及与视频荧光镜转诊相比的等待时间。结果 97% 接受 FEES 评估的患者年龄在 65 岁以上。患者的诊断范围包括虚弱(20%)、进行性神经系统疾病(18%)、其他(16.6%)、中风(13.3%)、慢性阻塞性肺病(13.3%)、获得性脑损伤(3%)、胃肠病(3%)和外科(3%)。97%的患者被确诊为吞咽困难,其中60%的患者在 "澳大利亚治疗结果衡量标准"(Australian Therapy Outcome Measures)中属于中度至重度吞咽困难。33%的患者表现为无声吸入,其中三分之一的患者无临床症状。经过 FEES 评估后,40% 的患者被建议改变饮食质地或液体浓度,其中 54% 和 70% 的患者分别被建议降低饮食或液体浓度。与转诊接受视频荧光镜检查(平均需要 24 天)相比,该服务能让患者更及时地接受仪器吞咽评估,平均在 4 天内完成 FEES 评估。结论 通过这项研究,我们了解了使用 FEES 的患者的情况。FEES 有助于更快地进行仪器吞咽评估和吸入识别。此外,它还实现了有针对性的以人为本的吞咽困难康复治疗。参考文献 1.Doan, T.N et al (2022) Prevalence and methods for assessment of oropharyngeal dysphagia in older adults: a systematic review and meta-analysis.临床医学杂志》,11(9),第 2605 页。
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来源期刊
Age and ageing
Age and ageing 医学-老年医学
CiteScore
9.20
自引率
6.00%
发文量
796
审稿时长
4-8 weeks
期刊介绍: Age and Ageing is an international journal publishing refereed original articles and commissioned reviews on geriatric medicine and gerontology. Its range includes research on ageing and clinical, epidemiological, and psychological aspects of later life.
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