A Nationwide Study of the Impact of Dysphagia on Hospital Outcomes among Patients with Dementia

Suchitra Paranji, Neethi Paranji, Scott Wright, Shalini Chandra

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives: To assess the impact of dysphagia on clinical and operational outcomes in hospitalized patients with dementia. Design: Retrospective cohort study. Setting: 2012 Nationwide Inpatient Sample. Participants: All patients discharged with a diagnosis of dementia (N = 234,006) from US hospitals in 2012. Measurements: Univariate and multivariate regression models, adjusting for stroke and patient characteristics, to assess the impact of dysphagia on the prevalence of comorbidities, including pneumonia, sepsis, and malnutrition; complications, including mechanical ventilation and death; and operational outcomes, including length of stay (LOS) and total charges for patients with dementia. Results: Patients having dementia with dysphagia (DWD) had significantly higher odds of having percutaneous endoscopic gastrostomy placement during the admission (odds ratio [OR]: 13.68, 95% confidence interval [CI]: 12.53-14.95, P <.001), aspiration pneumonia (OR: 6.27, 95% CI: 5.87-6.72, P <.001), pneumonia (OR: 2.84, 95% CI: 2.67-3.02, P <.001), malnutrition (OR: 2.5, 95% CI: 2.27-2.75, P <.001), mechanical ventilation (OR: 1.69, 95% CI: 1.51-1.9, P <.001), sepsis (OR: 1.52, 95% CI: 1.39-1.67, P <.001), and anorexia (OR: 1.29, 95% CI: 1.01-1.65, P =.04). Mean LOS was 2.16 days longer (95% CI: 1.98-2.35, P <.001), mean charge per case was US$10,703 higher (95% CI: US$9396-US$12,010, P <.001), and the odds of being discharged to a skilled nursing, rehabilitation, or long-term facility was 1.59 times higher (95% CI: 1.49-1.69, P <.001) in the DWD cohort compared to patients having dementia without dysphagia. Conclusion: Dysphagia is a significant predictor of worse clinical and operational outcomes including a 38% longer LOS and a 30% increase in charge per case among hospitalized patients with dementia. Although these findings may not be surprising, this new evidence might bring heightened awareness for the need to more thoughtfully support patients with dementia and dysphagia who are hospitalized.

Original languageEnglish (US)
Pages (from-to)5-11
Number of pages7
JournalAmerican Journal of Alzheimer's Disease and Other Dementias
Volume32
Issue number1
DOIs
StatePublished - Feb 2017

Keywords

  • NIS
  • cost
  • dementia
  • dysphagia
  • resource utilization

ASJC Scopus subject areas

  • Neuroscience(all)
  • Clinical Psychology
  • Geriatrics and Gerontology
  • Psychiatry and Mental health

Fingerprint Dive into the research topics of 'A Nationwide Study of the Impact of Dysphagia on Hospital Outcomes among Patients with Dementia'. Together they form a unique fingerprint.

Cite this