Impact of a Multidisciplinary Round Visit for the Management of Dysphagia Utilizing a Wi-Fi–Based Wireless Flexible Endoscopic Evaluation of Swallowing

Sakakura, Koichi; Tazawa, Masayuki; Otani, Natsuko; Takagi, Masaaki; Morita, Mariko; Kurosaki, Minori; Chiyoda, Tomoko; Kanai, Yuri; Endo, Akinori; Murata, Takaaki; Shino, Masato; Yokobori, Yuki; Shirakura, Kenji; Wada, Naoki; Chikamatsu, Kazuaki

doi:10.1177/0003489416674223

Cited by 5 publications

(6 citation statements)

References 11 publications

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“…Novel interventions such as use of wi-fi-based wireless flexible endoscopic or the swallowing provocation test (SPT) and the simple SPT (S-SPT) for evaluation of swallowing among inpatients have been shown to detect silent aspiration and reduce risk of aspiration pneumonia and number of deaths during hospitalization. [27][28][29] Early behavioral swallowing intervention including intensive speech therapy and dietary modification in inpatients with dysphagia and stroke has been associated with increased proportion of patients who returned to normal diet and recovered swallowing by 6 months. 30 In another group with acute intracerebral hemorrhage, early intervention program for oral feeding with intensive oral care and early behavioral interventions was associated with lower incidence of chest infection (OR 0.48, 95% CI 0.26-0.88) and greater proportion of patients who could tolerate oral feeding (OR 3.13, 95% CI 1.59-6.15) compared to control group.…”

Section: Discussionmentioning

confidence: 99%

Economic and survival burden of dysphagia among inpatients in the United States

Patel

Krishnaswami

Steger³

et al. 2017

Diseases of the Esophagus

195

112

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The inpatient burden of dysphagia has primarily been evaluated in patients with stroke. It is unclear whether dysphagia, irrespective of cause, is associated with worse clinical outcomes and higher costs compared to inpatients with similar demographic, hospital, and clinical characteristics without dysphagia. The aim of this study is to assess how a dysphagia diagnosis affects length of hospital stay (LOS), costs, discharge disposition, and in-hospital mortality among adult US inpatients. Annual and overall dysphagia prevalence, LOS, hospital charges, inpatient care costs, discharge disposition, and in-hospital mortality were measured using the AHRQ Healthcare Cost and Utilization Project (HCUP) National Inpatient Sample (2009-2013). Patients aged 45 years or older with ≤180 days of stay in hospital with and without dysphagia were included. Multivariable survey regression methods with propensity weighting were used to assess associations between dysphagia and different outcomes. Overall, 2.7 of 88 million (3.0%) adult US inpatients had a dysphagia diagnosis (50.2% male, 72.4% white, 74.6% age 65-90 years) and prevalence increased from 408,035 (2.5% of admissions) in 2009 to 656,655 (3.3%) in 2013. After inverse probability of treatment weighting adjustment, mean hospital LOS in patients with dysphagia was 8.8 days (95% CI 8.66-8.90) compared to 5.0 days (95% CI 4.97-5.05) in the non-dysphagia group (P < 0.001). Total inpatient costs were a mean $6,243 higher among those with dysphagia diagnoses ($19,244 vs. 13,001, P < 0.001). Patients with dysphagia were 33.2% more likely to be transferred to post-acute care facility (71.9% vs. 38.7%, P < 0.001) with an adjusted OR of 2.8 (95% CI 2.73-2.81, P < 0.001). Compared to non-cases, adult patients with dysphagia were 1.7 times more likely to die in the hospital (95% CI 1.67-1.74). Dysphagia affects 3.0% of all adult US inpatients (aged 45-90 years) and is associated with a significantly longer hospital length of stay, higher inpatient costs, a higher likelihood of discharge to post-acute care facility, and inpatient mortality when compared to those with similar patient, hospital size, and clinical characteristics without dysphagia. Dysphagia has a substantial health and cost burden on the US healthcare system.

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Section: Discussionmentioning

confidence: 99%

Economic and survival burden of dysphagia among inpatients in the United States

Patel

Krishnaswami

Steger³

et al. 2017

Diseases of the Esophagus

195

112

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“…35 In addition, past studies indicated that the information derived from FEES facilitates the discussion between various practitioners, it does not require radiation exposure, and moreover, very severe patients can benefit from FEES. 18,20,36 These studies suggested that the FEES could be one of the most beneficial tools for accurate diagnosis of patients with dysphagia at homes or facilities. On the other hand, the reliability and validity of using the PAS for FEES has been proven in the past, 23 and it was also useful in the scoring method in this study.…”

Section: Discussionmentioning

confidence: 99%

“…Considering the aforementioned background, there have been many reports on FEES use in recent years 2,18‐20 . However, there have been few studies on the use of FEES in patients with dysphagia in home‐visit dental care including hospitals, facilities, and at homes.…”

Section: Introductionmentioning

confidence: 99%

“…18 Considering the aforementioned background, there have been many reports on FEES use in recent years. 2,[18][19][20] However, there have been few studies on the use of FEES in patients with dysphagia in home-visit dental care including hospitals, facilities, and at homes. We aimed to examine the clinical significance of evaluating the swallowing function using FEES and DI during home-visit dental care in patients with dysphagia.…”

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confidence: 99%

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Effectiveness of fibreoptic endoscopic evaluation of swallowing and dietary intervention during home‐visit dental care in older individuals

et al. 2021

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Background Currently, patients with dysphagia are receiving dietary management that deviates from their original swallowing function. Objective To evaluate the clinical significance of fibreoptic endoscopic evaluation of swallowing (FEES) and dietary intervention (DI) by multi‐professional collaboration during visit care for determining the actual oral intake status in patients with dysphagia. Methods Five hundred and eighteen patients with dysphagia underwent FEES, focusing on the penetration‐aspiration scale, and DI. Oral intake status was categorised using the functional oral intake scale (FOIS). FOIS scores at the first visit, after FEES, and at the reassessment were compared. Results At the first visit, 34.7% of the patients had an FOIS score of level 1 (no oral intake) and 65.3% had a score of level 2 or higher (capable of oral intake). Following FEES, 7.1% of patients had an FOIS score of level 1, and 44.4% had a score of level 2 with resumption of oral intake. At the reassessment, 489 patients (94.4%) were capable of oral ingestion (FOIS level 2 or higher). There were significant differences between the distributions of FOIS scores at the first visit and following FEES (P < .01) and between those at the first visit and at the reassessment (P < .01). Regarding tube feeding, 17 (5.9%) of 289 patients, who had received tube feeding at the first visit, were completely capable of oral intake following FEES and at the reassessment. Conclusion Appropriate evaluation of swallowing function using FEES and DI helps to understand the definite swallowing function in patients with dysphagia.

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“…Moreover, the application of spectral narrow-band filters improved the detection rate and precise localization of minor bolus residue enhancing the diagnostic accuracy of penetration and aspiration [ 18 , 138 ]. The further development of low-cost video capturing systems including applications for the smartphone is ongoing, as is the use of Wi-Fi-based wireless FEES systems [ 139 , 140 ].…”

Section: Future Developments For Feesmentioning

confidence: 99%

Phoniatricians and otorhinolaryngologists approaching oropharyngeal dysphagia: an update on FEES

Schindler

Baijens

Geneid

et al. 2021

Eur Arch Otorhinolaryngol

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Impact of a Multidisciplinary Round Visit for the Management of Dysphagia Utilizing a Wi-Fi–Based Wireless Flexible Endoscopic Evaluation of Swallowing

Abstract: Wi-Fi-based wireless FEES system, the first of its kind, allowed our multidisciplinary team to easily and effectively assess inpatients with dysphagia by facilitating simple examinations and intensive transprofessional discussions for patient rehabilitation.

Cited by 5 publications

References 11 publications

Economic and survival burden of dysphagia among inpatients in the United States

Economic and survival burden of dysphagia among inpatients in the United States

Effectiveness of fibreoptic endoscopic evaluation of swallowing and dietary intervention during home‐visit dental care in older individuals

Phoniatricians and otorhinolaryngologists approaching oropharyngeal dysphagia: an update on FEES

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