0100483340

open access

Accepted Manuscript

Postoperative dysphagia as a predictor of functional decline and prognosis after undergoing cardiovascular surgery

English (英語)

European Journal of Cardiovascular Nursing

22(6)

602-609

Oxford University Press

2022-09-13

2023-10-12

【Aims】 Post-extubation dysphagia (PED), an often overlooked problem, is a common and serious complication associated with mortality and major morbidity after cardiovascular surgery. Dysphagia is considered an age-related disease, and evaluating its long-term effects is a pressing issue with rapidly progressing ageing worldwide. Therefore, we examined the effect of PED on functional status and long-term cardiovascular events in patients undergoing cardiovascular surgery. 【Methods and results】 This single-centre, retrospective cohort study included 712 patients who underwent elective cardiovascular surgery and met the inclusion criteria. Patients were divided into PED and non-PED groups based on their post-operative swallowing status. The swallowing status was assessed using the Food Intake Level Scale. Functional status was evaluated as hospital-associated disability (HAD), defined as a decrease in activities of daily living after hospital discharge compared with preoperative values. The patients were subsequently followed up to detect major adverse cardiac and cerebrovascular events (MACCEs). Post-extubation dysphagia was present in 23% of the 712 patients and was independently associated with HAD (adjusted odds ratio, 2.70). Over a 3.5-year median follow-up period, MACCE occurred in 14.1% of patients. Multivariate Cox proportional hazard analysis revealed HAD to be independently associated with an increased risk of MACCE (adjusted hazard ratio, 1.85), although PED was not significantly associated with MACCE. 【Conclusion】 Post-extubation dysphagia was an independent HAD predictor, with the odds of HAD occurrence being increased by 2.7-fold due to PED. Hospital-associated disability accompanied by PED is a powerful predictor of poor prognosis. Perioperative evaluation and management of the swallowing status, and appropriate therapeutic interventions, are warranted.

Hospital-associated disability

学術雑誌論文

This is a pre-copyedited, author-produced version of an article accepted for publication in European Journal of Cardiovascular Nursing following peer review. The version of record [Masato Ogawa, Seimi Satomi-Kobayashi, Mari Hamaguchi, Kodai Komaki, Kazuhiro P Izawa, Shunsuke Miyahara, Takeshi Inoue, Yoshitada Sakai, Ken-ichi Hirata, Kenji Okada, Postoperative dysphagia as a predictor of functional decline and prognosis after undergoing cardiovascular surgery, European Journal of Cardiovascular Nursing, Volume 22, Issue 6, August 2023, Pages 602–609] is available online at: https://doi.org/10.1093/eurjcn/zvac084.