Postorotracheal intubation dysphagia in patients with COVID-19: A retrospective study
| Autor: | Mariana Saconato, Jean Henri Maselli-Schoueri, Ceila Maria Sant’Ana Malaque, Rosa Maria Marcusso, Augusto César Penalva de Oliveira, Lucio Antonio Nascimento Batista, Graziela Ultramari, José Angelo Lauletta Lindoso, Maria Inês Rebelo Gonçalves, Jaques Sztajnbok |
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| Jazyk: | angličtina |
| Rok vydání: | 2024 |
| Předmět: | |
| Zdroj: | São Paulo Medical Journal, Vol 142, Iss 6 (2024) |
| Druh dokumentu: | article |
| ISSN: | 1806-9460 1516-3180 |
| DOI: | 10.1590/1516-3180.2022.0608.r3.14032024 |
| Popis: | ABSTRACT BACKGROUND: The cause of oropharyngeal dysphagia in patients with coronavirus disease (COVID-19) can be multifactorial and may underly limitations in swallowing rehabilitation. OBJECTIVE: Analyze the factors related to dysphagia in patients with COVID-19 immediately after orotracheal extubation and the factors that influence swallowing rehabilitation. DESIGN AND SETTING: A retrospective study. METHODS: The presence of dysphagia was evaluated using the American Speech-Language Hearing Association National Outcome Measurement System (ASHA NOMS) scale and variables that influenced swallowing rehabilitation in 140 adult patients who required invasive mechanical ventilation for >48 h. RESULTS: In total, 46.43% of the patients scored 1 or 2 on the ASHA NOMS (severe dysphagia) and 39.29% scored 4 (single consistency delivered orally) or 5 (exclusive oral diet with adaptations). Both the length of mechanical ventilation and the presence of neurological disorders were associated with lower ASHA NOMS scores (odds ratio [OR]: 0.80, 95% confidence interval [CI]: 0.74–0.87 P < 0.05; and OR: 0.13, 95% CI: 0.61–0.29; P < 0.05, respectively). Age and the presence of tracheostomy were negatively associated with speech rehabilitation (OR: 0.92; 95% CI: 0.87–−0.96; OR: 0.24; 95% CI: 0.80–−0.75), and acute post-COVID-19 kidney injury requiring dialysis and lower scores on the ASHA NOMS were associated with longer time for speech therapy outcomes (β: 1.62, 95% CI, 0.70–3.17, P < 0.001; β: −1.24, 95% CI: −1.55–−0.92; P < 0.001). CONCLUSION: Prolonged orotracheal intubation and post-COVID-19 neurological alterations increase the probability of dysphagia immediately after extubation. Increased age and tracheostomy limited rehabilitation. |
| Databáze: | Directory of Open Access Journals |
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