Effect of flexible endoscopic evaluation of swallowing on clinical functional outcomes in patients with intensive care unit-acquired swallowing disorders
10.3760/cma.j.cn115330-20250411-00225
- VernacularTitle:喉镜吞咽功能评估对重症监护室获得性吞咽障碍临床功能结局的影响
- Author:
Yandong SUN
1
;
Lixia HAO
;
Yan ZHANG
;
Naqi ZHOU
;
Zhiyu JIAO
;
Ying JIAO
;
Yihuan DONG
;
Ling XU
;
Huri LETEMUER
Author Information
1. 内蒙古医科大学附属医院康复医学科，呼和浩特 010030
- Publication Type:Journal Article
- Keywords:
Dysphagia;
Intensive care unit;
Pneumonia;
Clinical functional outcomes
- From:
Chinese Journal of Otorhinolaryngology Head and Neck Surgery
2025;60(11):1383-1388
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the effect of fiberoptic endoscopic evaluation of swallowing (FEES) on clinical functional outcomes of patients with intensive care unit-acquired swallowing disorders (ICU-ASD).Methods:This retrospective cohort study analyzed clinical data of patients diagnosed with post-extubation dysphagia (PED) in the intensive care unit (ICU) and respiratory intensive care unit (RICU) of the Affiliated Hospital of Inner Mongolia Medical University from February 2020 to February 2025. Patients were categorized into a FEES group of 60 cases [34 males, 26 females, aged 37-80 years (median age 62 years)] and a control group without FEES of 58 cases [32 males, 26 females, aged 39-77 years (median age 61 years)].The patients in two groups received swallowing function and feeding training based on the results of the FEES assessment and the Volume-Viscosity Swallow Test-Clinical Version (VVST-CV), respectively. Clinical functional outcome measures included pneumonia incidence, clinical pulmonary infection score (CPIS), pneumonia severity index (PSI), Functional Oral Intake Scale (FOIS), and dietary method at discharge. χ2 test, Mann-Whitney U test, and Wilcoxon signed-rank test, were employed for statistical analysis of the outcome measures. Results:Compared with the control group, the FEES group had significantly lower aspiration pneumonia incidence at discharge [3.3% (2/60) vs 15.5% (9/58), χ2=5.179, P=0.023]. Regarding dietary methods,a significantly higher proportion of patients in the FEES group achieved complete oral feeding compared with the control group [75.0% (45/60) vs 67.3% (39/58), χ2=8.065, P<0.05]. After training, the FEES group had higher median FOIS scores than the control group (7.00 vs 6.00, Z=-2.370, P=0.018), and lower CPIS scores (2.50 vs 5.00, Z=-2.216, P=0.027) and PSI scores (59.00 vs 73.00, Z=-2.251, P=0.024). Within-group comparisons revealed that FOIS scores significantly improved post-training in both groups (both P<0.001). Conclusion:Early FEES examination for ICU patients with acquired swallowing disorders is associated with a lower incidence of pneumonia, improved swallowing function, and superior clinical functional outcomes.
