The Impact of Dysphagia on Mortality of Nursing Home Residents: Results From the nutritionDay Project

Wirth R, Pourhassan M, Streicher M, Hiesmayr M, Schindler K, Sieber C, Volkert D (2018)

Publication Status: Published

Publication Type: Journal article

Publication year: 2018

Journal

Journal of the American Medical Directors Association Elsevier

Publisher: ELSEVIER SCIENCE INC

Book Volume: 19

Pages Range: 775-778

Journal Issue: 9

DOI: 10.1016/j.jamda.2018.03.016

Abstract

Objectives: Dysphagia is a frequent finding in nursing home residents. The aim of this study is to evaluate the association of dysphagia and mortality in nursing home residents and identify further risk factors for mortality in residents with dysphagia.Design: One-day, annually repeated cross-sectional study, evaluating the nutritional situation of nursing home residents with 6-month mortality as outcome.Setting: 191 nursing homes from 14 countries in Europe and the United States participating in the nutritionDay study between 2007 and 2012.Participants: Data of all nursing home residents in the nutritionDay study aged 65 years or older with available information about dysphagia and outcome were analyzed.Measurements: Residents' characteristics and mortality rate were calculated by group comparison, and mortality risk was calculated by multivariate regression analysis with adjustment for potential confounding factors.Results: 10,185 residents (78% female) with a mean age of 85 +/- 8.1 years were included in the analysis. Dysphagia was reported in 15.4% of residents. The 6-month mortality of residents with dysphagia was significantly higher than of those without dysphagia (24.7% vs 11.9%; P<.001). The multivariate regression analysis revealed dysphagia [odds ratio (OR) 1.44, 95% confidence interval (CI) 1.24-1.68, P<.001] along with body mass index <20 (OR 1.78, 95% CI 1.55-2.03, P<.001) and weight loss >5 kg (OR 1.61, 95% CI 1.37-1.88, P<.001) as independent and significant risk factors for mortality. Because of significant interaction, a disproportionately high mortality of 38.9% was found in residents with dysphagia accompanied by previous weight loss >5 kg (OR for interaction 1.44; 95% CI 1.03-2.01; P=.032). Tube feeding was reported in 14.6% of residents with dysphagia. The mortality rate of dysphagic residents receiving tube feeding vs those who were not was not significantly different (21.4% vs 25.3%; P=.244).Conclusion: In this nutritionDay study, dysphagia was identified as an independent risk factor for mortality in nursing home residents. Residents with dysphagia accompanied by weight loss are at a particularly high risk of mortality and should therefore receive special attention. (C) 2018 AMDA - The Society for Post-Acute and Long-Term Care Medicine.

Authors with CRIS profile

Melanie Streicher Professur für Klinische Ernährung im Alter Cornel Sieber Lehrstuhl für Innere Medizin (Geriatrie) Dorothee Volkert Professur für Klinische Ernährung im Alter

Involved external institutions

Medizinische Universität Wien AT Austria (AT) Ruhr-Universität Bochum (RUB) DE Germany (DE)

How to cite

APA:

Wirth, R., Pourhassan, M., Streicher, M., Hiesmayr, M., Schindler, K., Sieber, C., & Volkert, D. (2018). The Impact of Dysphagia on Mortality of Nursing Home Residents: Results From the nutritionDay Project. Journal of the American Medical Directors Association, 19(9), 775-778. https://dx.doi.org/10.1016/j.jamda.2018.03.016

MLA:

Wirth, Rainer, et al. "The Impact of Dysphagia on Mortality of Nursing Home Residents: Results From the nutritionDay Project." Journal of the American Medical Directors Association 19.9 (2018): 775-778.

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