Retrospective study of dysphagia following hospital discharge of intensive care patients

Objective

A retrospective study to assess the incidence and causal factors associated with long-term dysphagia following intensive care discharge.

Methods

A questionnaire was sent out 4 months post ICU discharge to 193 intensive care patients (Level 3 care with a stay of over 48 hours). We reviewed the case notes of those patients who reported swallowing difficulties to establish whether they had undergone, had any characteristics of or received therapies potentially associated with dysphagia.

Results

We had a 50% response rate to our questionnaire. An overall dysphagia post ICU stay rate of 19.5% was observed. Fever and age over 65 were both common findings as one may expect and showed the highest association with subsequent dysphagia. We did not find any suggestion of a relationship between changing tracheostomy (suggesting repeat procedures) and subsequent difficulty swallowing. One patient within this group subsequently developed a tracheal stenosis. See Table 1.

Table 1 (abstract P149)

Conclusion

We found the percentage of patients reporting swallowing difficulties post percutaneous tracheostomy (PCT) (Portex Blue Line Ultra tracheostomy tube) to be higher than one would expect. This may be confounded by neurological injury necessitating the need for a PCT, but we feel this may be an area of concern meriting further investigation given frequent PCT in ICU practice.