Dysphagia Prevalence and Predictors in Cancers Outside the Head, Neck, and Upper Gastrointestinal Tract
| Autor: | Ray McDermott, Declan Walsh, Stephen Higgins, Lucy Balding, Julie Regan, Eoin Tiernan, Ciarán Kenny, John Armstrong, Alina Mihai, Fergal C. Kelleher, Pierre Thirion, Jennifer Westrup, Norma O'Leary |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Male Pediatrics medicine.medical_specialty Palliative care Nausea Context (language use) Aspiration pneumonia 03 medical and health sciences Upper Gastrointestinal Tract 0302 clinical medicine Quality of life Predictive Value of Tests Neoplasms Surveys and Questionnaires otorhinolaryngologic diseases medicine Prevalence Humans 030212 general & internal medicine General Nursing Aged Gastrointestinal Neoplasms Aged 80 and over Performance status business.industry Malnutrition Palliative Care Hospices Middle Aged medicine.disease Dysphagia Deglutition Swallow Evaluation Anesthesiology and Pain Medicine Cross-Sectional Studies Head and Neck Neoplasms 030220 oncology & carcinogenesis Quality of Life Female Neurology (clinical) medicine.symptom business Deglutition Disorders |
| Zdroj: | Journal of pain and symptom management. 58(6) |
| ISSN: | 1873-6513 |
| Popis: | Context Dysphagia is usually associated with malignancies of the head, neck, and upper gastrointestinal tract but also occurs in those with tumors outside anatomic swallow regions. It can lead to aspiration pneumonia, malnutrition, reduced quality of life, and psychosocial distress. No studies have yet reliably described dysphagia prevalence in those with malignancies outside anatomic swallow regions. Objective The objective of this study was to establish the prevalence and predictors of dysphagia in adults with solid malignancies outside the head, neck, and upper gastrointestinal tract. Methods A cross-sectional, observational study using consecutive sampling was conducted. There were 385 participants (mean age 66 ± 12 years) with 21 different primary cancer sites from two acute hospitals and one hospice. Locoregional disease was present in 33%, metastatic in 67%. Dysphagia was screened by empirical questionnaire and confirmed through swallow evaluation. Demographic and clinical predictors were determined by univariate and multivariate binary regression. Results Dysphagia occurred in 19% of those with malignancies outside anatomic swallow regions. Prevalence was 30% in palliative care and 32% in hospice care. Dysphagia was most strongly associated with cough, nausea, and worse performance status. It was also associated with lower quality of life and nutritional difficulties. Conclusion Dysphagia was common and usually undiagnosed before study participation. It occurred at all disease stages but coincided with functional decline. It may therefore represent a cancer frailty marker. Oncology and palliative care services should routinely screen for this symptom. Timely dysphagia identification and management may improve patient well-being and prevent adverse effects like aspiration pneumonia and weight loss. |
| Databáze: | OpenAIRE |
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