Prevalence and clinical correlates of oropharyngeal dysphagia and malnutrition inhospitalized adult patients: A prospective observational Study.

INTRODUCTION: This study aimed to evaluate prevalence and clinical correlates of oropharyngeal dysphagia (OD) and malnutrition in hospitalized adult patients and to characterize 6-month outcomes among patients with OD at baseline. METHODS: A total of 1955 consecutive patients (mean±SD age: 56.8±16.23 years, 54.8% were males) hospitalized at a tertiary center were included. Data on Eating Assessment Tool (EAT-10), Mini Nutritional Assessment (MNA), functional oral intake scale (FOIS) and Holden functional ambulation classification scale (Holden FAC) were recorded. Patients diagnosed with dysphagia at baseline were re-evaluated at 6 months. RESULTS: Malnutrition and dysphagia were noted in 42.5% and 22.6% of patients, respectively. Dysphagia symptoms were highly prevalent (22.5% to 66.8%). Multivariate analysis revealed increase in EAT-10 scores with lower MNA scores (B, -0.206; 95% CI, -0.327 to -0.085; p=0.001), lower FOIS scores (B, -0.902; 95% CI, -1.349 to -0.455; p<0.001) and non-solid diet type (B, -1.311; 95% CI, -2.169 to -0.454; p=0.003). In addition, decrease in MNA scores (likelihood of malnutrition) was predicted by higher EAT-10 scores (B, -0.073; 95% CI, -0.114 to -0.031; p=0.001), lower FOIS scores (B, 0.440; 95% CI, 0.191 to 0.688; p=0.001), lower Holden FAC scores (B, 0.753; 95% CI, 0.622 to 0.883; p<0.001), non-solid diet (B, -1.178; 95% CI, -1.647 to -0.710; p<0.001) and previous hospitalization (B, -0.744; 95% CI, -1.259 to -0.229; p=0.005). Of the 441 patients with OD at baseline, 137 (31.1%) died and 59 (13.4%) were lost to follow-up. Among the 245 patients reassessed at 6 months, OD persisted in 81 (33.1%) and resolved in 164 (66.9%). Persistent OD was associated with higher baseline EAT-10 scores and lower baseline MNA and FOIS scores. CONCLUSION: In conclusion, our findings revealed higher prevalence of malnutrition alongside OD and highly prevalent dysphagia symptoms in hospitalized patients. Importantly, a considerable proportion of patients demonstrate persistent dysphagia at 6 months, highlighting the need for early identification and long-term follow-up. Presence of OD or malnutrition seems to significantly predict the risk of each other, while higher EAT and lower MNA scores were also associated with poor ambulatory status and decreased functional oral intake.