Research paper|Articles in Press

Dysphagia in adult intensive care patients: Results of a prospective, multicentre binational point prevalence study

  • Amy Freeman-Sanderson
    Corresponding author. University of Technology Sydney, Graduate School of Health, PO Box 123, Broadway, NSW, 2007, Australia.
    Graduate School of Health, University of Technology Sydney, NSW, Australia

    Royal Prince Alfred Hospital, Sydney, NSW, Australia

    Critical Care Division, The George Institute for Global Health, Faculty of Medicine, UNSW Sydney, Sydney, Australia

    Australian and New Zealand Intensive Care Research Centre (ANZIC-RC), School of Public Health and Preventive Medicine, Monash University, Australia
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  • Bronwyn Hemsley
    Graduate School of Health, University of Technology Sydney, NSW, Australia

    The University of Newcastle, NSW, Australia
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  • Kelly Thompson
    Critical Care Division, The George Institute for Global Health, Faculty of Medicine, UNSW Sydney, Sydney, Australia

    Nepean Blue Mountains Local Health District, Sydney, NSW, Australia
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  • Kris D. Rogers
    Graduate School of Health, University of Technology Sydney, NSW, Australia

    Statistics Division, The George Institute for Global Health, Faculty of Medicine, UNSW Sydney, Sydney, Australia
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  • Serena Knowles
    Critical Care Division, The George Institute for Global Health, Faculty of Medicine, UNSW Sydney, Sydney, Australia
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  • Naomi E. Hammond
    Critical Care Division, The George Institute for Global Health, Faculty of Medicine, UNSW Sydney, Sydney, Australia

    Malcolm Fisher Department of Intensive Care, Royal North Shore Hospital, Sydney, Australia
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  • On behalf ofThe George Institute for Global Health and the Australian and New Zealand Intensive Care Society Clinical Trials Group
Published:March 01, 2023DOI:



      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.


      The objective of this study was to describe the prevalence of dysphagia in nonintubated adult patients in the ICU.


      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).


      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.


      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.


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