Affiliation:
1. Hospital Universitari Germans Trias i Pujol
2. University Hospital Germans Trias i Pujol: Hospital Universitari Germans Trias i Pujol
3. Hospital de Mataró: Hospital de Mataro
4. Hospital Germans Trias i Pujol: Hospital Universitari Germans Trias i Pujol
Abstract
Abstract
BACKGROUND. Severe SARS-CoV-2 pneumonia has brought intensive care units (ICUs) and the consequences of prolonged hospitalisation, such as dysphagia, into focus.METHODS. Study population: Patients with severe pneumonia due to SARS-CoV-2 who required admission to critical units from March to June 2020. Dysphagia diagnostic method: Modified Viscosity Volume Swallowing Test (mV-VST). Objectives. To identify risk factors for dysphagia in patients with severe SARS-CoV-2 pneumonia requiring invasive mechanical ventilation and determine their incidence. Statistical analysis: Descriptive analysis of means or medians according to the normality of quantitative variables and proportions for the descriptive variables (95% CI). Univariate analysis of dysphagia using simple logistic regression. Multivariate analysis and construction of a predictive model for dysphagia using logistic regression.RESULTS. Descriptive analysis. Sample size: 232 patients; 72% (167) required intubation. Of these, 65.9% (110) survived and 84.5% (93) underwent the mV-VST, which diagnosed 26.9% (25) with dysphagia. Age: 60.5 years (95% CI: 58.5 to 61.9). Men: 74.1% (95% CI: 68.1 to 79.4). APACHE II score: 17.7 (95% CI: 13.3 to 23.2). Mechanical ventilation: 14 days (95% CI: 11 to 16); prone position: 79% (95% CI: 72.1 to 84.6); respiratory infection: 34.5% (95% CI: 28.6 to 40.9). Renal failure: 38.5% (95% CI: 30 to 50). Overall mortality: 25.9% (95% CI: 20.6 to 31.9). Mortality in intubated patients: 34.1% (95% CI: 27.3 to 41.7). No patient diagnosed with dysphagia died. Univariate analysis. APACHE II, prone position, days of mechanical ventilation and need for tracheostomy, respiratory infection, kidney failure developed during admission and length of ICU and hospital stay were significantly associated (p<0.05) with dysphagia. Multivariate analysis. Dysphagia is independently explained by APACHE II score (OR: 1.1; 95% CI: 1.01 to 1.3; p=0.04) and tracheostomy (OR: 10.2; 95% CI: 3.2 to 32.1; p<0.001). The resulting predictive model predicts dysphagia with a good ROC curve (AUC: 0.8; 95% CI: 0.7 to 0.9)CONCLUSIONS. Dysphagia affects almost one-third of patients, and the risk of developing dysphagia increases with prolonged mechanical ventilation, tracheostomy and greater severity on admission (APACHE II score).
Publisher
Research Square Platform LLC
Cited by
5 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献