Dysphagia outcomes in COVID-19 patients: experiences in long-term acute care hospital (LTACH)

Purpose Long term acute care hospitals (LTACHs) saw a significant increase in COVID-19 patients with prolonged acute illness recovery. Speech language pathologists (SLP) in LTACHs were integral in assessing swallowing and providing rehabilitation for dysphagia, however, there is limited research on LTACHs and dysphagia. Our aim was to describe this unique dysphagia management experience to improve future patient care. Methods Retrospective chart reviews were conducted for patients admitted to RML Specialty Hospital for respiratory failure secondary to COVID-19 from April 1, 2020 to October 31, 2021. Demographic information, videofluoroscopic swallow study (VFSS) reports with Penetration and Aspiration Scale (PAS) scores and SLP notes were reviewed. Descriptive statistics and chi-square analysis were performed. Results A total of 213 patients met inclusion criteria. Most patients presented with tracheostomy (93.9%) and were NPO (92.5%) on admission. A strong correlation (p = 0.029) was noted between dependence on mechanical ventilation and significant airway invasion, as indicated by PAS score of 7 or 8 on VFSS. There was a strong association (p = 0.001) between patients who had tracheostomy placed within 33 days of VFSS and recommendation for thin liquids. Upon discharge, the majority of patients (83.57%) transitioned successfully to oral diets, however, a strong association (p = 0.009) between higher age (≥ 62) and NPO at discharge was demonstrated. Conclusion Patients admitted post COVID-19 to LTACH, especially those requiring tracheostomy, demonstrated various degrees of dysphagia and benefited from SLP intervention and instrumental swallow assessments. Most patients admitted to LTACH for COVID-19 were successfully rehabilitated for dysphagia..

Medienart:

Artikel

Erscheinungsjahr:

2023

Erschienen:

2023

Enthalten in:

Zur Gesamtaufnahme - volume:280

Enthalten in:

European archives of oto-rhino-laryngology and head & neck - 280(2023), 9 vom: 24. Mai, Seite 4255-4260

Sprache:

Englisch

Beteiligte Personen:

Rajski, Barbara [VerfasserIn]
Furey, Vicki [VerfasserIn]
Nguyen, Alvin [VerfasserIn]
Duffner, Lisa A. [VerfasserIn]
Young, Bryce [VerfasserIn]
Husain, Inna A. [VerfasserIn]

Links:

Volltext [lizenzpflichtig]

Themen:

COVID-19
Dysphagia
LTACH
Tracheostomy
Ventilatory dependency

RVK:

RVK Klassifikation

Anmerkungen:

© The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

doi:

10.1007/s00405-023-08032-7

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

OLC2144728178