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Examining the relationship between sepsis and oropharyngeal dysphagia in hospitalised elderly patients: a retrospective cohort study
  1. Ayodele Sasegbon1,
  2. Laura O’Shea2,
  3. Shaheen Hamdy1
  1. 1 Gastrointestinal (GI) Sciences, Division of Diabetes, Endocrinology and Gastroenterology, School of Medical Sciences, Salford Royal Hospital (part of the Manchester Academic Health Sciences Centre (MAHSC)), Salford, UK
  2. 2 Salford Royal Hospital, Salford, UK
  1. Correspondence to Dr Ayodele Sasegbon, Gastrointestinal (GI) Sciences, Division of Diabetes, Endocrinology and Gastroenterology, School of Medical Sciences, Salford Royal Hospital (part of the Manchester Academic Health Sciences Centre (MAHSC)), Salford M6 8HD, UK; ayodele.sasegbon{at}manchester.ac.uk

Abstract

Introduction Elderly people are recognised to be at increased risk of oropharyngeal dysphagia (OPD), the causes of which are multifactorial. Our aim was to identify if sepsis is associated with OPD in the elderly during hospitalisation in the absence of known other risk factors for OPD.

Methods A hospital electronic database was searched for elderly patients (≥65 years) referred for assessment for suspected dysphagia between March 2013 and 2014. Exclusion criteria were age <65 years, pre-existing OPD or acute OPD secondary to acute intracranial event, space-occupying lesion or trauma. Data were collected on factors including age, sex, comorbidities, existing OPD, sepsis, microbiology, recovery of OPD and medication. Sepsis was defined as evidence of a systemic inflammatory response syndrome with a clinical suspicion of infection.

Results A total of 301 of 1761 screened patients referred for dysphagia assessment met the inclusion criteria. The prevalence of sepsis and subsequent OPD was 16% (51/301). The mean age was 83 years (median 81 years). The most common comorbidity was dementia (31%). The majority (84%) failed to recover swallowing during their hospital stay, 12% had complications of aspiration and 35% died. The most common source of sepsis was from the chest (55%). Other factors contributing to the risk for dysphagia included delirium (22%) and neuroactive medication (41%). However, 10% of patients had sepsis and subsequent OPD without other identified risk factors.

Conclusion The prevalence of sepsis and subsequent dysphagia is significant and should be taken into account in any elderly person in hospital with new-onset OPD without other predisposing risk factors.

  • sepsis
  • dysphagia
  • elderly

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Footnotes

  • Contributors Ayodele Sasaegbon planned the study, collected the data, wrote and submitted the paper. Shaheen Hamdy helped plan the study and write the paper. Laura O’Shea provided access to the speech and language therapy database.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Not required.

  • Ethics approval London Bromley research ethics committee (REC no. 15/LO/1413).

  • Provenance and peer review Not commissioned; externally peer reviewed.

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