Association between Dysphagia and Surgical Outcomes across the Continuum of Frailty

J Nutr Gerontol Geriatr. 2021 Apr-Jun;40(2-3):59-79. doi: 10.1080/21551197.2021.1929644. Epub 2021 May 28.

Abstract

This study examined the relationship between dysphagia and adverse outcomes across frailty conditions among surgical patients ≥50 years of age. A retrospective cohort analysis of surgical hospitalizations in the Healthcare Cost and Utilization Project's National Inpatient Sample among patients ≥50 years of age undergoing intermediate/high risk surgery not involving the larynx, pharynx, or esophagus. Of 3,298,835 weighted surgical hospitalizations, dysphagia occurred in 1.2% of all hospitalizations and was higher in frail patients ranging from 5.4% to 11.7%. Dysphagia was associated with greater length of stay, higher total costs, increased non-routine discharges, and increased medical/surgical complications among both frail and non-frail patients. Dysphagia may be an independent risk factor for poor postoperative outcomes among surgical patients ≥50 years of age across frailty conditions and is an important consideration for providers seeking to reduce risk in vulnerable surgical populations.

Keywords: Dysphagia; frailty; outcomes; surgery.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.
  • Research Support, N.I.H., Extramural

MeSH terms

  • Aged
  • Deglutition Disorders* / diagnosis
  • Deglutition Disorders* / epidemiology
  • Deglutition Disorders* / physiopathology
  • Female
  • Frailty* / diagnosis
  • Frailty* / epidemiology
  • Frailty* / physiopathology
  • General Surgery / statistics & numerical data
  • Hospitalization / economics
  • Hospitalization / statistics & numerical data
  • Humans
  • Length of Stay / statistics & numerical data
  • Male
  • Outcome Assessment, Health Care
  • Postoperative Complications* / classification
  • Postoperative Complications* / diagnosis
  • Postoperative Complications* / physiopathology
  • Risk Adjustment / methods*
  • Surgical Procedures, Operative* / adverse effects
  • Surgical Procedures, Operative* / statistics & numerical data