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What is the value of fibre-endoscopic evaluation of swallowing (FEES) in neurological patients? A cross-sectional hospital-based registry study.

Abstract：

OBJECTIVES:Fibre-endoscopic evaluation of swallowing (FEES) to detect dysphagia is gaining more and more importance as a diagnostic tool. Therefore, we have investigated the impact of FEES in neurological patients in a clinical setting. DESIGN:Cross-sectional hospital-based registry. SETTING:Primary acute care in a neurological department of a German university hospital. PARTICIPANTS:241patients with various neurological diseases who underwent FEES procedure. PRIMARY AND SECONDARY OUTCOME MEASURES:Dysphagia and related comorbidities. RESULTS:267 FEES were performed in 241 patients with various neurological diagnoses. Dysphagia was diagnosed in 68.9% of the patients. In only 33.1% of the patients, appropriate oral diet was chosen prior to FEES. A relevant dysphagia occurred more often in patients with structural brain lesions (83.1% vs 65.3%, P=0.001), patients with dysphagia had a longer hospitalisation (median 18 (IQR 12-30) vs 15 days (IQR 9.75-22.75), P=0.005) and had a higher mortality (8.4% vs 1.3%, P=0.041). When the oral diet was changed, we observed a lower pneumonia rate (36% vs 50%, P=0.051) and a lower mortality (3.7% vs 11.3%, P=0.043) in comparison to no change of oral diet. A restriction of oral diet was identified more often in older patients (median 75 years (IQR 66.3-82 years) vs median 72 years (IQR 60-79 years), P=0.01) and in patients with structural brain lesions (86.8% vs 73.1%, P=0.05). CONCLUSION:On clinical investigation, dysphagia was misjudged for the majority of the patients. FEES might help to compensate this drawback, revising the diet regime in nearly 70% of the patients.

journal_name

BMJ Open

journal_title

BMJ open

authors

Braun T,Juenemann M,Viard M,Meyer M,Fuest S,Reuter I,Kaps M,Prosiegel M,Tanislav C

doi

10.1136/bmjopen-2017-019016

subject

Has Abstract

pub_date

2018-03-06 00:00:00

pages

e019016

issue

3

issn

2044-6055

pii

bmjopen-2017-019016

journal_volume

8

pub_type

杂志文章

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