Incidence of dysphagia-related safety incidents in older adults across feeding methods: A systematic review and meta-analysis

IF 4 3区医学 Q1 GERIATRICS & GERONTOLOGY Journal of Nutrition Health & Aging Pub Date : 2025-05-01 Epub Date: 2025-02-21 DOI:10.1016/j.jnha.2025.100522

Yingying Zhang , Zhina Gong , Jianzheng Cai , Weixia Yu , Yinuo Dai , Haifang Wang

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Abstract

Objective

Dysphagia-related safety incidents encompass near-miss events, no-harm occurrences, or harmful incidents associated with oral or enteral feeding methods. This systematic review and meta-analysis aimed to assess the incidence rates of dysphagia-related safety incidents in older adults across various feeding methods.

Methods

A comprehensive literature search was conducted using PubMed, Embase, Web of Science, Cochrane Library, and CINAHL databases to identify studies reporting dysphagia-related safety incidents in older adults. The feeding methods analyzed included oral feeding, nasogastric (NG) tube feeding, and percutaneous endoscopic gastrostomy (PEG) tube feeding. Randomized controlled trials (RCTs), non-randomized studies, and cohort studies were included. The analysis adhered to the PRISMA guidelines, and meta-analytic outcomes were presented with 95% confidence intervals (CIs).

Results

A total of 30 studies satisfied the inclusion criteria. The overall incidence rates of safety incidents were 13.8% for oral feeding, 23.9% for NG tube feeding, and 26.5% for PEG tube feeding. Aspiration pneumonia emerged as the most prevalent safety incident across all feeding methods, with incidence rates of 12.0% for oral feeding, 20.6% for NG tube feeding, and 12.4% for PEG tube feeding. Tube feeding methods were associated with diarrhea and wound infection. Additionally, specialized safety incidents were observed for each feeding method: suffocation in oral feeding; gastroesophageal reflux in NG tube feeding; and tube blockage, tube dislodgment, tube leakage, vomiting, nausea, site pain, gastrointestinal hemorrhage, and peritonitis in PEG tube feeding.

Conclusions

Dysphagia-related safety incidents in older adults demonstrated considerable variability in type and frequency across different feeding methods. Understanding these differences could provide healthcare professionals with valuable insights for targeted risk prediction and proactive management strategies to mitigate such incidents.

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不同喂养方式老年人吞咽困难相关安全事件的发生率：一项系统回顾和荟萃分析

目的吞咽困难相关安全事件包括与口服或肠内喂养方法相关的未遂事件、无伤害事件或有害事件。本系统综述和荟萃分析旨在评估不同喂养方式下老年人吞咽困难相关安全事件的发生率。方法使用PubMed、Embase、Web of Science、Cochrane Library和CINAHL数据库进行全面的文献检索，以确定报告老年人吞咽困难相关安全事件的研究。研究的喂养方式包括口服喂养、鼻胃管喂养和经皮内镜胃造口管喂养。包括随机对照试验（rct）、非随机研究和队列研究。该分析遵循PRISMA指南，meta分析结果以95%置信区间（ci）呈现。结果共有30项研究符合纳入标准。口腔喂养的总体安全事故发生率为13.8%，NG管饲为23.9%，PEG管饲为26.5%。吸入性肺炎是所有喂养方式中最常见的安全事件，口服喂养的发生率为12.0%，NG管喂养的发生率为20.6%，PEG管喂养的发生率为12.4%。管饲方法与腹泻和伤口感染相关。此外，还观察了每种喂养方式的特殊安全事件：口腔喂养窒息；胃食管反流；在PEG管饲中出现管堵塞、管移位、管漏、呕吐、恶心、部位疼痛、胃肠道出血、腹膜炎。结论：老年人吞咽困难相关安全事件在不同喂养方法的类型和频率上存在相当大的差异。了解这些差异可以为医疗保健专业人员提供有价值的见解，用于有针对性的风险预测和主动管理策略，以减轻此类事件。

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来源期刊

Journal of Nutrition Health & Aging 医学-老年医学

CiteScore

7.80

自引率

3.40%

发文量

136

审稿时长

4-8 weeks

期刊介绍： There is increasing scientific and clinical interest in the interactions of nutrition and health as part of the aging process. This interest is due to the important role that nutrition plays throughout the life span. This role affects the growth and development of the body during childhood, affects the risk of acute and chronic diseases, the maintenance of physiological processes and the biological process of aging. A major aim of "The Journal of Nutrition, Health & Aging" is to contribute to the improvement of knowledge regarding the relationships between nutrition and the aging process from birth to old age.