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Dysphagia is an independent predictor of hospital-acquired disability in older patients with heart failure: a propensity score-matched analysis

Predictors of HAD in older HF patients

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Abstract

This study aims to identify the relationship between dysphagia and developing hospital-acquired disability (HAD) in older patients with heart failure (HF). This single-center retrospective cohort study included 360 patients (median age, 84 years: 58.1% female, 41.9% male) who had undergone rehabilitation and were aged 65 years and older. Patients were divided into dysphagia and non-dysphagia groups and compared based on the Functional Oral Intake Scale score. HAD was defined as a decline in the Barthel Index score (indication of daily activity levels) at discharge relative to that before admission. The relationship between dysphagia and HAD was analyzed using bivariate analysis after adjusting for age, sex, body mass index, medical history, clinical and laboratory data, short physical performance battery (SPPB), and cognitive function at the start of rehabilitation, using propensity score matching. HAD was observed in 38.1% of the patients. Patients with dysphagia were significantly older, and had lower body mass index and physical and cognitive function than those without. After propensity score matching, the prevalence of HAD was significantly higher in the dysphagia group than in the non-dysphagia group (61.9% vs. 42.9%, P = 0.032). Dysphagia at the start of rehabilitation was an independent predictor of HAD. The results of this study may contribute to risk stratification of HAD.

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Data availability

The data that support the findings of this study are available from the corresponding author upon reasonable request.

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Acknowledgements

The authors gratefully acknowledge the participation of all study patients and thank all colleagues in our department for their contributions to the medical care of patients.

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Authors and Affiliations

  1. Division of Comprehensive Rehabilitation Sciences, Hirosaki University Graduate School of Health Sciences, 66-1, Hon-cho, Hirosaki, Aomori, Hirosaki, 036-8564, Japan

    Junichi Yokota

  2. Department of Clinical Research, National Hospital Organization Sendai Medical Center, Sendai, Japan

    Junichi Yokota

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

    Ren Takahashi, Takaaki Chiba, Yuko Matsukawa, Keisuke Matsushima & Kosuke Sasaki

Authors
  1. Junichi Yokota
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  2. Ren Takahashi
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  3. Takaaki Chiba
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  4. Yuko Matsukawa
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  5. Keisuke Matsushima
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  6. Kosuke Sasaki
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Contributions

Conceptualization: JY; data curation: JY and RT; formal analysis: JY; investigation: JY, RT, TC, YM, KM, and KS; methodology: JY; project administration: JY and RT; supervision: JY; validation: JY; visualization: JY; writing: JY. All authors read and approved the final version of the manuscript.

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Correspondence to Junichi Yokota.

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Research involving human participants, their data or biological material

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The study was approved by the Bioethics Committee of the Sendai Medical Center (Approval No. 20-70).

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Yokota, J., Takahashi, R., Chiba, T. et al. Dysphagia is an independent predictor of hospital-acquired disability in older patients with heart failure: a propensity score-matched analysis. Heart Vessels 38, 66–76 (2023). https://doi.org/10.1007/s00380-022-02133-9

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  • DOI: https://doi.org/10.1007/s00380-022-02133-9

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