• Nutrition · Nov 2024

    Temporal recovery and prognostic factors for dysphagia following cardiovascular surgery: Retrospective analysis and development of predictive score.

    • Nao Hashida, Kiyohito Hosokawa, Ai Kawamura, Motoyuki Suzuki, Itsuki Kitayama, Masayuki Nozawa, Eri Okajima, Madoka Sugamoto, Akinari Sugauchi, Wataru Sahara, Shigeru Miyagawa, and Hidenori Inohara.
    • Swallowing Center, Osaka University Hospital, Suita city, Osaka, Japan. Electronic address: nhashida@ent.med.osaka-u.ac.jp.
    • Nutrition. 2024 Nov 1; 127: 112534112534.

    ObjectiveDysphagia is a common complication associated with cardiovascular surgery (CVS). This study sought to better understand recovery timelines, identify risk factors, and create a prognostic model for oral intake restoration.MethodsThis retrospective study included 134 patients who had CVS between April 2022 and March 2024. We assessed swallowing ability through fiberoptic endoscopic evaluation of swallowing (FEES). We randomly divided the patients' data into a training dataset and a test dataset in a ratio of 70/30 and Kaplan-Meier analyses and Cox regression were used to assess predictors of total oral intake. We also created a scoring system using the estimated regression coefficients.ResultsMost patients with CVS achieved total oral intake in 7-11 days after extubation. Over 168 h of intubation, the presence of penetration or aspiration, a poor FEES score (score > 6), and perioperative complications were significant risk factors for delayed total oral intake. The predicting score was calculated by adding the scores for each individual factor, including FEES score, penetration/aspiration, and preoperative complications. Scores ranged 0-8, categorizing patients into 0-2, 3-5, and 6-8 groups, clearly demonstrating that the higher the predicting score, the longer the time to total oral intake in both the training and the test dataset.ConclusionsAll risk factors for unsuccessful or delayed total oral intake were intubation for more than a week, poor swallowing ability, and the presence of perioperative complications. The scoring system accurately predicts the restoration of oral intake following CVS.Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.

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