Dysphagia worsens short-term outcomes in patients with acute exacerbation of heart failure

Heart Vessels. 2020 Oct;35(10):1429-1438. doi: 10.1007/s00380-020-01617-w. Epub 2020 May 2.

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; Functional oral intake scale; Heart failure; Short-term outcomes.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Deglutition Disorders / diagnosis
  • Deglutition Disorders / mortality
  • Deglutition Disorders / physiopathology*
  • Deglutition Disorders / therapy
  • Deglutition*
  • Disease Progression
  • Female
  • Heart Disease Risk Factors
  • Heart Failure / diagnosis
  • Heart Failure / mortality
  • Heart Failure / physiopathology*
  • Heart Failure / therapy
  • Hospital Mortality
  • Humans
  • Length of Stay
  • Longitudinal Studies
  • Male
  • Risk Assessment
  • Severity of Illness Index
  • Stroke Volume*
  • Time Factors
  • Ventricular Function, Left*