Malnutrición asociada a disfagia orofaríngea en pacientes mayores de 65 años ingresados en una unidad médico-quirúrgica
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2014
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Elsevier
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Galán Sánchez-Heredero, M.J. et al. (2014) «Malnutrición asociada a disfagia orofaríngea en pacientes mayores de 65 años ingresados en una unidad médico-quirúrgica», Enfermería clínica, 24(3), pp. 183-190. doi:10.1016/J.ENFCLI.2013.12.009.
Abstract
Objetivos: El objetivo principal es conocer la relación existente entre disfagia orofaríngea, situación de riesgo nutricional y deterioro funcional en pacientes mayores de 65 años ingresados en una unidad de hospitalización médico-quirúrgica. Los objetivos secundarios son determinar la prevalencia de disfagia orofaríngea, conocer el estado nutricional y la capacidad funcional de estos pacientes.
Metodología: Estudio observacional, analítico y transversal que incluyó durante los meses de febrero a marzo del 2013 a pacientes mayores de 65 años ingresados en la unidad de Digestivo-Urología del Hospital Universitario de la Princesa. Se registraron las siguientes variables: edad, sexo, índice de masa corporal, soporte familiar, diagnóstico, comorbilidad, disfagia orofaríngea (EAT-10 y método de evaluación clínica volumen-viscosidad), malnutrición (Mininutritional Assessment) y capacidad funcional de los pacientes (índice de Barthel).
Resultados: Se reclutó a 167 pacientes, siendo la prevalencia de disfagia y de malnutrición del 30,8 y 15,4% respectivamente. En pacientes con disfagia orofaríngea la prevalencia de problemas nutricionales aumentó hasta el 75%.
En el análisis de regresión logística, la obtención de una puntuación baja en el índice de Barthel (OR 0,97 [IC 95%; 0,95-0,99]), la presencia de comorbilidad (OR 7,98 [IC 95%; 3,09-20,61]) y padecer disfagia (OR 4,07 [IC 95%; 1,57-10,52]) se asociaron a una mayor probabilidad de padecer malnutrición.
Discusión: La disfagia orofaríngea es uno de los problemas más infradiagnosticados y subestimados entre los pacientes ancianos y que mayor afectación tiene sobre su estado nutricional. Sugerimos detectarla de forma precoz mediante los métodos diagnósticos establecidos y con la colaboración de un equipo multidisciplinar.
Aims: The main objective of this study was to understand the relationship between oropharyngeal dysphagia, nutritional risk factors and functional impairment in the elderly (>65y) admitted to a medical-surgical hospital unit. Secondary objectives were to determine the prevalence of oropharyngeal dysphagia, the nutritional status and their functional capacity. Methods: A cross-sectional observational study was performed. It included patients over 65 years of age admitted to the Gastroenterology-Urology Department in La Princesa University Hospital (Madrid, Spain) during the months of February and March. The following variables were recorded: age, sex, body mass index, family support, diagnosis, comorbidity, oropharyngeal dysphagia (EAT-10 and volume-viscosity evaluation method), malnutrition (Mininutritional Assessment) and functional capacity (Barthel index). Results: A total of 167 patients were recruited, with 30.8% and 15.4% prevalence of dysphagia and malnutrition, respectively. Prevalence of malnutrition increased to 75% in patients with oropharyn geal dysphagia. The logistic regression analysis showed how conditions as low score on the Barthel index (OR 0.97 [95% CI, 0.95-0.99]), comorbidity (OR 7.98 [CI 95%, 3.09-20.61]) and dysphagia (OR 4.07 [CI 95%, 1.57-10.52]) were associated with a greater likelihood of suffering malnutrition. Discussion: Oropharyngeal dysphagia is one of the most underdiagnosed and underestimated conditions among elderly patients and one that has a greater effect on their nutritional status. Accordingly, we suggest using established diagnostic methods with a multidisciplinary team collaboration for its early detection.
Aims: The main objective of this study was to understand the relationship between oropharyngeal dysphagia, nutritional risk factors and functional impairment in the elderly (>65y) admitted to a medical-surgical hospital unit. Secondary objectives were to determine the prevalence of oropharyngeal dysphagia, the nutritional status and their functional capacity. Methods: A cross-sectional observational study was performed. It included patients over 65 years of age admitted to the Gastroenterology-Urology Department in La Princesa University Hospital (Madrid, Spain) during the months of February and March. The following variables were recorded: age, sex, body mass index, family support, diagnosis, comorbidity, oropharyngeal dysphagia (EAT-10 and volume-viscosity evaluation method), malnutrition (Mininutritional Assessment) and functional capacity (Barthel index). Results: A total of 167 patients were recruited, with 30.8% and 15.4% prevalence of dysphagia and malnutrition, respectively. Prevalence of malnutrition increased to 75% in patients with oropharyn geal dysphagia. The logistic regression analysis showed how conditions as low score on the Barthel index (OR 0.97 [95% CI, 0.95-0.99]), comorbidity (OR 7.98 [CI 95%, 3.09-20.61]) and dysphagia (OR 4.07 [CI 95%, 1.57-10.52]) were associated with a greater likelihood of suffering malnutrition. Discussion: Oropharyngeal dysphagia is one of the most underdiagnosed and underestimated conditions among elderly patients and one that has a greater effect on their nutritional status. Accordingly, we suggest using established diagnostic methods with a multidisciplinary team collaboration for its early detection.