From delay to detection: Dysphagia patterns in tracheostomised ICU patients in South Africa

Background: Dysphagia in tracheostomised patients is highly prevalent but often underdiagnosed, especially in resource-constrained settings such as South Africa. Delays in referral and limited access to instrumental assessments further compromise the quality of care. There is limited data regarding the incidence and severity of dysphagia in patients with tracheostomies within this context. Objectives: This study aimed to evaluate the incidence of dysphagia in tracheostomised patients at a South African private intensive care unit (ICU) in order to understand and explore the need for context-appropriate, standardised practices of care in this population. Method: A retrospective file review was conducted on 68 adult patients who underwent fibreoptic endoscopic evaluation of swallowing (FEES) between July 2022 and January 2024. Data were extracted for 42 patients who had a tracheostomy at the time of assessment. Dysphagia severity was rated using the Penetration-Aspiration Scale (PAS). Descriptive statistics wer