Evaluación de la deglución con nasofibroscopia en pacientes hospitalizados: factores predictivos y seguimiento intrahospitalario: Experiencia en un hospital clínico universitario

Abstract

Functional endoscopic evaluation of swallowing among hospitalized patients Background: Swallowing disorders are common in hospitalized patients. Functional endoscopic evaluation of swallowing (FEES) is a simple, safe and effective test for the diagnosis and monitoring of these disorders. Aim: To report the results of functional endoscopic swallowing evaluation. Material and Methods: Retrospective review of all records of functional swallowing evaluation procedures performed in a 6 months period. Results: A total of 327 evaluations were analyzed. Sixty seven percent were performed for the fi rst time in a patient and 32.4% were follow-up evaluations. Mean age of patients was 73 ± 17 (SD) years and 56% were male. Twenty nine percent had prolonged orotracheal intubation (> 48 hours). Swallowing was evaluated as normal, mildly, moderately and severely altered in 8.2, 27, 27 and 38% of cases, respectively. Age (> 50 years) and orotracheal intubation were the most important predictors of severity (p = 0,01). Oral feeding was achieved during hospital stay in 78 and 55 % of patients with moderate or severe swallowing disorders, respectively, after a delay of 8.7 and 14.3 days, respectively. Having a severe swallowing disorder during the fi rst evaluation, increased fourfold the risk of gastrostomy. Conclusions: Most hospitalized patients with swallowing disorders achieve oral feeding before leaving hospital. Safe oral feeding is delayed as swallowing disorder is of greater severity.

Caracterización de pacientes hospitalizados con sospecha de disfagia en el Hospital San Camilo de San Felipe, Chile

“…A nivel nacional, existen escasos estudios que den cuenta de antecedentes clínicos que permitan describir a los pacientes con sospecha de disfagia. En la presente investigación, según los datos demográficos, 449 pacientes (58,54%) correspondieron a sujetos de sexo masculino, lo que coincide con otros estudios [20][21][22] .…”

A Pessoa com Alteração na Deglutição

“…O ramo mais interno, por outro é na sua maioria sensorial, sendo responsável pela sensibilidade laringofaríngea acima das pregas vocais. Pode-se então subentender que a disfagia pode ser causada por fatores motores, sensoriais, anatómicos ou mistos 10,11. A estimulação do córtex cerebral e do tronco cerebral podem desencadear diversos fenómenos envolvidos na deglutição.…”