Clinical predictors of dysphagia in patients with sepsis in a high-complexity hospital: insights for early identification

TL;DR

This study identifies clinical predictors of swallowing difficulties in sepsis patients, highlighting the need for early diagnosis and specialized care.

Contribution

The study provides insights into clinical predictors of dysphagia in sepsis patients in a high-complexity hospital setting.

Findings

Dysphagia in sepsis patients is linked to higher clinical severity and comorbidities like neurological and heart conditions.

Patients with dysphagia had lower FOIS scores, longer hospital stays, and higher mortality risks.

Clinical signs like prolonged oral transit time and aspiration indicators were frequently observed in dysphagic patients.

Abstract

To characterize the swallowing function of patients with sepsis, describe the frequency of oropharyngeal dysphagia, examine the rehabilitation duration required, and identify clinical predictors associated with the occurrence of dysphagia in a high-complexity hospital setting.

This cross-sectional observational study included 35 patients diagnosed with sepsis, whose clinical severity was assessed using the National Early Warning Score (NEWS). Clinical and demographic data were collected from medical records. All participants underwent an initial screening with the Yale Swallow Protocol, and those identified at risk for dysphagia were further evaluated using the Dysphagia Risk Evaluation Protocol – Screening (DREP) and the Protocol for Introduction and Transition to Oral Feeding (PITOF). Swallowing functionality was classified using the Functional Oral Intake Scale (FOIS).

Dysphagic patients had pulmonary infection as the primary source of sepsis, higher clinical severity, a greater prevalence of comorbidities such as neurological diseases and heart conditions, lower FOIS scores, increased need for alternative feeding routes, longer hospital stays, and a higher risk of mortality. The most frequent clinical signs included prolonged oral transit time, reduced laryngeal elevation, and aspiration indicators such as throat clearing and coughing after swallowing.

Oropharyngeal dysphagia in patients with sepsis is associated with worse clinical outcomes, emphasizing the importance of early diagnosis and specialized management.