Identification of Predictors of Adverse Health Outcomes in Acute Care Patients with Dysphagia

Purpose: Dysphagia, common among adult patients in acute care settings, is associated with various complications. This study aimed to identify significant predictors of adverse health outcomes in hospitalized patients with dysphagia. Methods: A consulting committee meeting preceded a retrospective chart review involving 420 adult patients (mean age 72 years, 55% male) hospitalized at CHU de Québec-Université Laval, who underwent an interdisciplinary dysphagia assessment. Multivariate logistic and linear regression analyses were conducted to examine relationships between potential predictors and outcomes (in-hospital mortality and pneumonia), with age and sex as covariates. Results: The consulting committee agreed that most predictors of adverse health outcomes, identified through the research team's clinical experience and existing literature, were both important and applicable to clinical practice. Stroke, head and neck cancer, all types of malnutrition, and unauthorized food intake were the most significant predictors of mortality (P < 0.04, for all). Intellectual disability, chronic obstructive pulmonary disease, gastroesophageal reflux, and severe malnutrition were the most significant predictors of pneumonia (P ≤ 0.02, for all). Conclusion: This study highlights the importance of addressing malnutrition as a significant modifiable risk factor for mortality and pneumonia among hospitalized patients with dysphagia. These findings underscore the need to manage high-risk patients with dysphagia effectively.