Relationships between high comorbidity index and nutritional parameters in patients with Oropharyngeal Dysphagia. (August 2020)

• Record Type: Journal Article
• Authors: da Silva, Alice Freitas; Moreira, Emilia Addison Machado; Barni, Gabriela Cristofoli; Panza, Vilma Simões Pereira; Furkim, Ana Maria; Moreno, Yara Maria Franco
• Is Part Of: Clinical nutrition ESPEN. Volume 38(2020)
• Page Start: 218
• Page End: 222
• Publication Date: 2020-08
• Subjects: Swallowing disorders -- Multimorbidity -- Nutritional status -- Nutritional support -- Mortality; BMI Body Mass Index -- CCI Charlson Comorbidity Index -- 95%CI 95% Confidence Interval -- COPD Chronic Obstructive Pulmonary Disease -- DM Diabetes Mellitus -- FOIS Functional Oral Intake Scale -- IQR Interquartile Range -- nº-M/H Number of Medications and Hospitalization -- OD Oropharyngeal Dysphagia -- OR Odds Ratio; Nutritionally induced diseases -- Periodicals; Metabolism -- Disorders -- Periodicals; 616.39005
• DOI: 10.1016/j.clnesp.2020.04.008
• Languages: English
• ISSNs: 2405-4577

Abstract

Summary: Background & aims: Oropharyngeal dysphagia (OD) and comorbidities can exert an influence on nutritional status and contribute to mortality. The aim of the present study was to examine relationships between high Charlson Comorbidity Index (CCI) scores and OD outcomes, including OD severity, feeding route, nutritional status and one-year mortality rate in adults and elderly individuals. Methods: A longitudinal study, whose the final sample comprised 110 patients with OD and 75 of whom were evaluated for one-year mortality outcome. Swallowing (videofluoroscopy), nutritional status [body mass index (BMI)], CCI, type of feeding route, medications and hospitalization were evaluated. Multinomial logistic regression was performed to calculate the unadjusted and adjusted odds ratios (OR) and 95% confidence intervals (95%CI). Results: Overall sample of the study were adults and elders with a median age (years) of 61.3 [interquartile range (IQR): 58.4–64.2]. The median CCI was 2.3 (IQR: 2.1–2.6) and the mortality rate was 10.8%. Hospitalization was significantly associated with underweight (p = 0.013) and number of medications (p = 0.023). After adjustment, sex/age and nº-Medications/Hospitalization (nº-M/H), CCI ≥3 was associated with nasogastric tube feeding (OR 4.57, 95%CI 1.59–13.1 and OR 3.39, 95%CI 1.21–9.51 respectively) and swallowing performance (OR 0.73, 95%CI 0.59–0.90 and OR 0.74, 95%CI 0.61–0.90 respectively). Conclusions: A high CCI was associated with OD severity and feeding route, but not with nutritional status or mortality. Highlights: Mortality is higher in older, comorbid and hospitalized patients. Comorbidities are associated with use of nasogastric tube and dysphagia severity. Between the prevalent comorbidities are neurological and neurodegenerative diseases.