Abstract
Background
Dysphagia occurs in intensive care unit (ICU) patients. However, there is a lack of
epidemiological data on the prevalence of dysphagia in adult ICU patients.
Objectives
The objective of this study was to describe the prevalence of dysphagia in nonintubated
adult patients in the ICU.
Methods
A prospective, multicentre, binational, cross-sectional point prevalence study was
conducted in 44 adult ICUs in Australia and New Zealand. Data were collected in June
2019 on documentation of dysphagia, oral intake, and ICU guidelines and training.
Descriptive statistics were used to report demographic, admission, and swallowing
data. Continuous variables are reported as means and standard deviations (SDs). Precisions
of estimates were reported as 95% confidence intervals (CIs).
Results
Of the 451 eligible participants, 36 (7.9%) were documented as having dysphagia on
the study day. In the dysphagia cohort, the mean age was 60.3 years (SD: 16.37) vs
59.6 years (SD: 17.1) and almost two-thirds were female (61.1% vs 40.1%). The most
common admission source for those patients with dysphagia were from the emergency
department (14/36, 38.9%), and seven of 36 (19.4%) had a primary diagnosis of trauma
(odds ratio: 3.10, 95% CI 1.25 - 7.66). There were no statistical differences in Acute
Physiology and Chronic Health Evaluation (APACHE II) scores between those with and
without a dysphagia diagnosis. Patients with dysphagia were more likely to have a
lower mean body weight of 73.3 kg vs 82.1 kg than patients not documented as having
dysphagia (95% CI of mean difference: 0.43 to 17.07) and require respiratory support (odds ratio: 2.12,
95% 1.06 to 4.25). The majority of patients with dysphagia were prescribed modified
food and fluids in the ICU. Less than half of ICUs surveyed reported unit-level guidelines,
resources, or training for management of dysphagia.
Conclusions
The prevalence of documented dysphagia in adult ICU nonintubated patients was 7.9%.
There were a higher proportion of females with dysphagia than previously reported.
Approximately two-thirds of patients with dysphagia were prescribed oral intake, and
the majority were receiving texture-modified food and fluids. Dysphagia management
protocols, resources, and training are lacking across Australian and New Zealand ICUs.
Keywords
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Article info
Publication history
Published online: March 01, 2023
Accepted:
January 8,
2023
Received in revised form:
December 21,
2022
Received:
August 22,
2022
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2023 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. All rights reserved.
