Association between swallowing function and Short Physical Performance Battery score in hospitalized adults with heart failure: A retrospective cohort study

BACKGROUND: Dysphagia is a common complication in acute heart failure, and approximately 20% of patients develop new-onset dysphagia during hospitalization. Although dysphagia has been associated with worse prognosis, most studies rely on subjective scales, and objective assessment in heart failure remains insufficiently standardized. We examined whether ultrasonographic swallowing function at admission was associated with physical function at discharge and prognosis in patients with acute heart failure. METHODS: We retrospectively studied 166 patients aged ≥65 years emergently admitted for acute heart failure to Sagamihara Kyodo Hospital between August 2021 and December 2022. Ultrasonographic swallowing function was assessed using maximal hyoid displacement, geniohyoid muscle area, and geniohyoid muscle echogenicity at admission. Outcomes were Short Physical Performance Battery at discharge and a 1-year composite of all-cause death or heart failure-related unplanned readmission. RESULTS: Median age was 82 years and 46% were women. In adjusted linear regression models, greater maximal hyoid displacement (β = 0.19; P < 0.001), larger geniohyoid muscle area (β = 0.04; P = 0.02), and lower geniohyoid muscle echogenicity (β = -0.08; P = 0.01) were associated with higher Short Physical Performance Battery scores at discharge. Over a follow-up period, 55 patients had the composite endpoint. In the multivariate Cox proportional hazards model, lower maximal hyoid displacement, smaller geniohyoid muscle area, and higher geniohyoid muscle echogenicity were associated with worse prognosis (P < 0.05). CONCLUSION: Ultrasonographic swallowing function was associated with discharge physical function and 1-year prognosis in older patients with acute heart failure.