Impact of post-hospitalization dysphagia on dependence in activities of daily living at discharge in older adults with hip fracture: A nationwide inpatient database study

IF 2.9 Q3 NUTRITION & DIETETICS

Clinical nutrition ESPEN Pub Date : 2025-03-22 DOI:10.1016/j.clnesp.2025.03.041

Shuntaro Tamura , Tomohiko Kamo , Sota Kobayashi , Hiroyuki Saito , Tatsuya Igarashi , Yoichi Kaizu , Kazuhiro Miyata , Hiroki Kubo , Hirofumi Ogihara , Ryo Momosaki

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引用次数: 0

Abstract

Background

Older adults with hip fractures of the femur have a higher probability of developing dysphagia after surgery. Dysphagia affects older patients with hip fractures in multiple ways, thus clinicians need to understand the impact of dysphagia on the effectiveness of treatment.

Aims

The aim of this study is to clarify the impact of dysphagia on dependence in activities of daily living in older adults with hip fractures.

Methods

This retrospective observational study utilized a nationwide inpatient database, encompassing acute inpatient care from 2017 to 2022. Older adults (≥60 years) with hip fractures who underwent surgery and survived to discharge were included. Dysphagia was analyzed as a factor affecting dependence in activities of daily living at discharge using binomial logistic regression and the inverse probability of treatment weighting (IPTW) method, which was based on propensity scores.

Results

The analysis included 88,809 older adults with hip fractures. Binomial logistic regression analysis showed that dysphagia was significantly associated with dependence in activities of daily living, with an odds ratio of 3.24 (95 % confidence interval [CI], 2.72–3.85; p < 0.01). Furthermore, sensitivity analysis confirmed these findings. After adjusting for IPTW, dysphagia remained a significant factor for dependence in activities of daily living at discharge, with an odds ratio of 2.55 (95 % CI, 2.45–2.64; p < 0.01).

Conclusions

In older adults with hip fractures, dysphagia negatively affects the activities of daily living at discharge. These results are useful for clinicians for understanding the significance of preventing dysphagia development.

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住院后吞咽困难对髋部骨折老年人出院时日常生活活动依赖的影响：一项全国住院患者数据库研究

背景：老年股骨髋部骨折患者术后发生吞咽困难的可能性较高。吞咽困难以多种方式影响老年髋部骨折患者，因此临床医生需要了解吞咽困难对治疗效果的影响。目的：本研究的目的是阐明老年髋部骨折患者吞咽困难对日常生活活动依赖的影响。方法：本回顾性观察性研究利用全国住院患者数据库，包括2017年至2022年的急性住院治疗。老年人（≥65岁）髋部骨折患者接受手术并存活至出院。使用二项logistic回归和基于倾向评分的治疗加权逆概率（IPTW）方法分析吞咽困难作为出院时日常生活活动依赖的影响因素。结果：该分析包括88809名髋部骨折的老年人。二项logistic回归分析显示，吞咽困难与日常生活活动依赖显著相关，比值比为3.24(95%可信区间[CI]， 2.72 ~ 3.85；结论：老年髋部骨折患者出院时吞咽困难会对日常生活活动产生负面影响。这些结果有助于临床医生理解预防吞咽困难发展的重要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical nutrition ESPEN NUTRITION & DIETETICS-

CiteScore

4.90

自引率

3.30%

发文量

512

期刊介绍： Clinical Nutrition ESPEN is an electronic-only journal and is an official publication of the European Society for Clinical Nutrition and Metabolism (ESPEN). Nutrition and nutritional care have gained wide clinical and scientific interest during the past decades. The increasing knowledge of metabolic disturbances and nutritional assessment in chronic and acute diseases has stimulated rapid advances in design, development and clinical application of nutritional support. The aims of ESPEN are to encourage the rapid diffusion of knowledge and its application in the field of clinical nutrition and metabolism. Published bimonthly, Clinical Nutrition ESPEN focuses on publishing articles on the relationship between nutrition and disease in the setting of basic science and clinical practice. Clinical Nutrition ESPEN is available to all members of ESPEN and to all subscribers of Clinical Nutrition.