Identifying the Risk of Swallowing-Related Pulmonary Complications in Older Patients With Hip Fracture

Meals, Clifton; Roy, Snigdha; Medvedev, Gleb; Wallace, Matthew T.; Neviaser, Robert J.; O’Brien, Joseph R.

doi:10.3928/01477447-20151222-07

Cited by 12 publications

(19 citation statements)

References 25 publications

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“…Recently, Belmont Jr et al reported that pneumonia was diagnosed in just 4.6% of hip fracture patients, which is much lower than the percentage reported in the current study . This discrepancy might be attributed to the fact that the patients included in the present study and in that by Roche et al are older than those included in the study by Belmont Jr et al Dysphagia and aspiration pneumonia are more common among frail older patients owing to their impaired swallowing function . Furthermore, age has been reported as a risk factor of postoperative complications and mortality in hip fracture patients .…”

Section: Discussioncontrasting

confidence: 71%

“…10 This discrepancy might be attributed to the fact that the patients included in the present study and in that by Roche et al 9 are older than those included in the study by Belmont Jr et al 10 Dysphagia and aspiration pneumonia are more common among frail older patients owing to their impaired swallowing function. 16,18,22 Furthermore, age has been reported as a risk factor of postoperative complications and mortality in hip fracture patients. 9,20 In corroboration with these findings, age was identified as an independent risk factor of aspiration pneumonia after regression analysis in the present study as well.…”

Section: Discussionmentioning

confidence: 99%

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Risk factors and prognostic implications of aspiration pneumonia in older hip fracture patients: A multicenter retrospective analysis

Byun

Shon

Kim

et al. 2018

Geriatrics Gerontology Int

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Aim The present study aimed to investigate the risk factors and prognostic implications of aspiration pneumonia in older hip fracture patients. Methods A total of 394 female and 125 male hip fracture patients aged ≥60 years who underwent surgery between 2015 and 2018 were retrospectively analyzed. To identify risk factors of aspiration pneumonia, demographic factors, the American Society of Anesthesiologists classification, past medical history, known risk factors of aspiration and factors associated with surgery were compared between the aspiration pneumonia group and the control group. Regression analysis was also carried out. To assess the prognostic implications of aspiration pneumonia, hospital stay, frequency of the intensive care unit admission and in‐hospital mortality rates were compared between groups. Results Aspiration pneumonia was diagnosed in 8.8% of the hip fracture patients. Increased age, low body mass index, malnutrition, longer duration of surgery and delayed surgery were identified as risk factors of aspiration pneumonia. Regarding prognostic implications, hospital stay, the frequency of intensive care unit care and in‐hospital mortality rates were significantly higher in the aspiration pneumonia group (P < 0.001, <0.001 and 0.001, respectively). Conclusions Older hip fracture patients with aspiration pneumonia showed worse prognostic outcome compared with patients without aspiration pneumonia. Longer duration of surgery and delayed surgery, as well as patient characteristics including increased age, low body mass index and malnutrition were identified as risk factors for aspiration pneumonia. Therefore, surgeons should try to reduce the operation time and the time interval between injury and surgery when treating older patients for hip fractures. Geriatr Gerontol Int 2019; 19: 119–123.

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Section: Discussioncontrasting

confidence: 71%

Section: Discussionmentioning

confidence: 99%

Risk factors and prognostic implications of aspiration pneumonia in older hip fracture patients: A multicenter retrospective analysis

Byun

Shon

Kim

et al. 2018

Geriatrics Gerontology Int

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“…The subjects' physical condition before surgery was assessed by ASA scores (American Society of Anesthesiologists) [14,22]. The ASA physical status classifies the patients' fitness before surgery into 6 classes: (1) normal health, (2) mild systemic disease, (3) severe systemic disease, (4) severe life-threatening systemic disease, (5) a moribund patient, or (6) a brain-dead organ donor.…”

Section: Baseline Parametersmentioning

confidence: 99%

“…Cases of sarcopenia were reported in 17~58% of older patients with hip fractures [11][12][13]. Furthermore, dysphagia was reported to occur in 5.3~44% of patients who underwent operative treatment for hip fractures [14][15][16][17]. Dysphagia in older patients with hip fracture was associated with risk factors such as low serum albumin levels, female gender, confusion after surgery, and preoperative worsening of physical status [14][15][16][17].…”

Section: Introductionmentioning

confidence: 99%

“…Furthermore, dysphagia was reported to occur in 5.3~44% of patients who underwent operative treatment for hip fractures [14][15][16][17]. Dysphagia in older patients with hip fracture was associated with risk factors such as low serum albumin levels, female gender, confusion after surgery, and preoperative worsening of physical status [14][15][16][17]. In particular, no study has yet explored the association between sarcopenia and dysphagia following hip fracture.…”

Section: Introductionmentioning

confidence: 99%

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Association of Sarcopenic Dysphagia with Underlying Sarcopenia Following Hip Fracture Surgery in Older Women

et al. 2020

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This study aimed to investigate the association between the development of dysphagia in patients with underlying sarcopenia and the prevalence of sarcopenic dysphagia in older patients following surgical treatment for hip fracture. Older female patients with hip fractures (n = 89) were studied. The data of skeletal muscle mass, hand-grip strength, and nutritional status were examined. The development of dysphagia postoperatively was graded using the Food Oral Intake Scale by a certified nurse in dysphagia nursing. The patients’ mean age was 85.9 ± 6.5 years. The prevalence of sarcopenia was 76.4% at baseline. Of the 89 patients, 11 (12.3%) and 12 (13.5%) had dysphagia by day 7 of hospitalization and at discharge, respectively. All patients who developed dysphagia had underlying sarcopenia. Lower skeletal muscle mass index (SMI) (<4.7 kg/m2) and grip strength (<8 kg) at baseline indicated a higher incidence of dysphagia on day 7 (p = 0.003 and Phi = 0.391) and at discharge (p = 0.001 and Phi = 0.448). Dysphagia developed after hip fracture surgery could be sarcopenic dysphagia, and worsening sarcopenia was a risk factor for dysphagia following hip fracture surgery. Clinicians and medical coworkers should become more aware of the risks of sarcopenic dysphagia. Early detection and preventive interventions for dysphagia should be emphasized.

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Preoperative dysphagia risk in community‐dwelling adults aged ≥50 years: Prevalence and risk factors

et al. 2022

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Background: Preoperative dysphagia screening is rare. The purpose of this study was to assess the prevalence and potential risk factors of preoperative dysphagia risk in adults preparing for surgery. Methods:The Eating Assessment Tool (EAT-10), Patient-Generated Subjective Global Assessment Short Form (PG-SGA SF), and Sarcopenia Screening Tool (SARC-F) were self-administered in adults preparing for surgery to identify dysphagia, malnutrition, and sarcopenia risk, respectively. Other variables collected include clinical demographics, fall risk, and surgical history associated with increased dysphagia risk. Descriptive summary statistics, univariate analysis, and logistic regression were performed as appropriate.Results: The median age was 69 years and preoperative dysphagia risk was 9.6%. Among 357 patients completing both EAT-10 and PG-SGA SF or SARC-F, 7.3% had preoperative dysphagia and malnutrition risk and 7.2% had preoperative dysphagia and sarcopenia risk. Preoperative dysphagia risk was 2.7 times greater in those with prior surgical history associated with increased risk of dysphagia, 2.2 times higher in women, and almost twice as high in Black patients and patients with fall risk. Logistic regression revealed significant odds ratios (ORs) for prior surgical history associated with increased risk of dysphagia (OR, 2.95; 95% CI, 1.62-5.40) and male sex (OR, 0.52; 95% CI, 0.29-0.94), and a significant relationship between preoperative dysphagia and malnutrition risk (OR, 4.56; 95% CI, 2.02-10.28) when controlling for clinical variables. Conclusion:The high prevalence of dysphagia risk alone and in combination with malnutrition and sarcopenia risk in community-dwelling adults underscores the need for standardized preoperative screening and optimization prior to surgery.

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Identifying the Risk of Swallowing-Related Pulmonary Complications in Older Patients With Hip Fracture

Cited by 12 publications

References 25 publications

Risk factors and prognostic implications of aspiration pneumonia in older hip fracture patients: A multicenter retrospective analysis

Risk factors and prognostic implications of aspiration pneumonia in older hip fracture patients: A multicenter retrospective analysis

Association of Sarcopenic Dysphagia with Underlying Sarcopenia Following Hip Fracture Surgery in Older Women

Preoperative dysphagia risk in community‐dwelling adults aged ≥50 years: Prevalence and risk factors

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