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

Heart and Vessels volume 35, pages 1429–1438 (2020)Cite this article

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.

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Acknowledgements

The authors gratefully acknowledge the participation of all study patients and thank all colleagues in our department for their contribution to the medical care of the patients. Also, we would like to thank Editage (www.editage.jp) for English language editing.

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Affiliations

  1. Department of Internal Medicine and Rehabilitation Science Disability Science, Tohoku University Graduate School of Medicine, 1-1, Seiryo-cho, Aoba-ku, Sendai, Miyagi, 980-8574, Japan

    Junichi Yokota & Masahiro Kohzuki

  2. Department of Rehabilitation, National Hospital Organization Sendai Medical Center, Sendai, Miyagi, Japan

    Junichi Yokota

  3. Department of Sport and Medical Sciences, Teikyo University, Hachioji, Tokyo, Japan

    Yoshiko Ogawa

  4. Department of Cardiology, National Hospital Organization Sendai Medical Center, Sendai, Miyagi, Japan

    Yoshimi Takahashi, Nobuhiro Yamaguchi, Noriko Onoue & Tsuyoshi Shinozaki

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  1. Junichi Yokota
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  2. Yoshiko Ogawa
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  6. Tsuyoshi Shinozaki
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  7. Masahiro Kohzuki
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Correspondence to Masahiro Kohzuki.

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Yokota, J., Ogawa, Y., Takahashi, Y. et al. Dysphagia worsens short-term outcomes in patients with acute exacerbation of heart failure. Heart Vessels 35, 1429–1438 (2020). https://doi.org/10.1007/s00380-020-01617-w

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  • DOI: https://doi.org/10.1007/s00380-020-01617-w

Keywords

  • Dysphagia
  • Heart failure
  • Functional oral intake scale
  • Short-term outcomes