Dysphagia worsens short-term outcomes in patients with acute exacerbation of heart failure
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ORIGINAL ARTICLE
Dysphagia worsens short‑term outcomes in patients with acute exacerbation of heart failure Junichi Yokota1,2 · Yoshiko Ogawa3 · Yoshimi Takahashi4 · Nobuhiro Yamaguchi4 · Noriko Onoue4 · Tsuyoshi Shinozaki4 · Masahiro Kohzuki1 Received: 28 February 2020 / Accepted: 24 April 2020 © Springer Japan KK, part of Springer Nature 2020
Abstract Dysphagia, defined as a dysfunction in any stage or process of eating, is common in patients with acute exacerbation of heart failure (HF). In some diseases, dysphagia worsens in-hospital mortality, length of hospital stay, and discharge disposition. However, it remains unclear whether dysphagia is associated with poor short-term outcomes in HF patients. The objective of the present study was to determine whether dysphagia affects short-term outcomes in patients with acute exacerbation of HF. A total of 327 patients hospitalized with acute exacerbation of HF were eligible for the study. Patients were divided into a dysphagia group (DG) or a non-dysphagia group (NDG) based on results of the functional oral intake scale (FOIS), which evaluates a patient’s ability of eating and swallowing. FOIS is a 7-point scale, with a level of ≤ 5 indicating dysphagia. Following the withdrawal of 16 patients, short-term outcomes such as in-hospital mortality, length of hospital stay, and discharge disposition, of 311 patients were analyzed. All indexes of short-term outcomes were significantly worse in the DG than in the NDG. After propensity score matching, which was performed to adjust for baseline characteristics such as age, sex, height, weight, body mass index, medical history, complications, HF severity, ejection fraction, and biochemical data excluding nutritional status, all short-term outcomes remained significantly worse in the DG than in the NDG. Multivariate analysis showed that FOIS was an independent predictor of in-hospital survival, length of hospital stay, and discharge to home. The present study suggested that dysphagia affected short-term outcomes in patients with acute exacerbation of HF. Therefore, early detection and intervention of dysphagia in HF patients are important. Keywords Dysphagia · Heart failure · Functional oral intake scale · Short-term outcomes
Introduction The increase in the number of patients with heart failure (HF) is a global health problem. In Japan, with the rapid aging of the population, the number of new-onset HF cases in the * Masahiro Kohzuki [email protected] 1
Department of Internal Medicine and Rehabilitation Science Disability Science, Tohoku University Graduate School of Medicine, 1‑1, Seiryo‑cho, Aoba‑ku, Sendai, Miyagi 980‑8574, Japan
2
Department of Rehabilitation, National Hospital Organization Sendai Medical Center, Sendai, Miyagi, Japan
3
Department of Sport and Medical Sciences, Teikyo University, Hachioji, Tokyo, Japan
4
Department of Cardiology, National Hospital Organization Sendai Medical Center, Sendai, Miyagi, Japan
elderly aged ≥ 65 years has increased approximately two times compared to 20
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