Practice Patterns Related to Dysphagia After Anterior Cervical Spine Surgery: A Single-Center Retrospective Review.

IF 2.5 3区 医学 Q1 AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY
Jeffrey Wessell, Erin L Reedy, Janet Horn, Emily Lynn Schommer, Heather Shaw Bonilha
{"title":"Practice Patterns Related to Dysphagia After Anterior Cervical Spine Surgery: A Single-Center Retrospective Review.","authors":"Jeffrey Wessell, Erin L Reedy, Janet Horn, Emily Lynn Schommer, Heather Shaw Bonilha","doi":"10.1044/2025_AJSLP-24-00407","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>Dysphagia is a possible complication after anterior cervical spine surgery (ACSS). Studies indicate specific risk factors for dysphagia and that in a subset of patients, dysphagia post-ACSS is not transient. This study aimed to evaluate the impact of dysphagia after ACSS, investigate potential risk factors for its occurrence, assess modalities utilized to diagnose dysphagia, examine pertinent referral patterns, and explore the utilization of speech-language pathology services post-ACSS.</p><p><strong>Method: </strong>This retrospective study was performed using data from a tertiary academic medical center from patients post-ACSS over a 6-month period. Patient sociodemographic, surgical, and clinical information and diagnosis of dysphagia were recorded. Evaluation of risk factors for post-ACSS dysphagia, diagnostic modality utilized, complications, and referral patterns were assessed.</p><p><strong>Results: </strong>Among 106 patients post-ACSS, 17 (16%) were diagnosed with dysphagia. Preoperative dysphagia was the only significant risk factor for post-ACSS dysphagia (<i>OR</i> = 8.705). Patients with postoperative dysphagia had significantly higher rates of complications, including gastrostomy tube placement (<i>p</i> < .001), respiratory infection (<i>p</i> < .001), 30-day readmission rates (<i>p</i> < .001), and mortality (<i>p</i> = .004). Symptomatic patients were referred for evaluation 100% as inpatients but only 50% of the time as outpatients. Furthermore, swallowing was evaluated with an objective assessment in only 31.4% of patients with symptomatic dysphagia.</p><p><strong>Conclusions: </strong>In our post-ACSS cohort, we identified a relatively low incidence (16%) of patients diagnosed with dysphagia when compared with the literature. We also identified gaps between scientific knowledge and clinical practice, which was evidenced by the lack of pre- and postoperative screening for dysphagia, the relatively low use of instrumental swallowing exams, and the low referral rate for outpatient clinical swallowing assessments post-ACSS. We hope that the findings from this work prompt others to evaluate clinical practice patterns related to patients undergoing ACSS and inform focused quality improvement projects.</p>","PeriodicalId":49240,"journal":{"name":"American Journal of Speech-Language Pathology","volume":" ","pages":"2721-2735"},"PeriodicalIF":2.5000,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"American Journal of Speech-Language Pathology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1044/2025_AJSLP-24-00407","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/7/30 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY","Score":null,"Total":0}
引用次数: 0

Abstract

Purpose: Dysphagia is a possible complication after anterior cervical spine surgery (ACSS). Studies indicate specific risk factors for dysphagia and that in a subset of patients, dysphagia post-ACSS is not transient. This study aimed to evaluate the impact of dysphagia after ACSS, investigate potential risk factors for its occurrence, assess modalities utilized to diagnose dysphagia, examine pertinent referral patterns, and explore the utilization of speech-language pathology services post-ACSS.

Method: This retrospective study was performed using data from a tertiary academic medical center from patients post-ACSS over a 6-month period. Patient sociodemographic, surgical, and clinical information and diagnosis of dysphagia were recorded. Evaluation of risk factors for post-ACSS dysphagia, diagnostic modality utilized, complications, and referral patterns were assessed.

Results: Among 106 patients post-ACSS, 17 (16%) were diagnosed with dysphagia. Preoperative dysphagia was the only significant risk factor for post-ACSS dysphagia (OR = 8.705). Patients with postoperative dysphagia had significantly higher rates of complications, including gastrostomy tube placement (p < .001), respiratory infection (p < .001), 30-day readmission rates (p < .001), and mortality (p = .004). Symptomatic patients were referred for evaluation 100% as inpatients but only 50% of the time as outpatients. Furthermore, swallowing was evaluated with an objective assessment in only 31.4% of patients with symptomatic dysphagia.

Conclusions: In our post-ACSS cohort, we identified a relatively low incidence (16%) of patients diagnosed with dysphagia when compared with the literature. We also identified gaps between scientific knowledge and clinical practice, which was evidenced by the lack of pre- and postoperative screening for dysphagia, the relatively low use of instrumental swallowing exams, and the low referral rate for outpatient clinical swallowing assessments post-ACSS. We hope that the findings from this work prompt others to evaluate clinical practice patterns related to patients undergoing ACSS and inform focused quality improvement projects.

与颈椎前路手术后吞咽困难相关的练习模式:一项单中心回顾性研究。
目的:吞咽困难是颈椎前路手术(ACSS)后可能出现的并发症。研究表明吞咽困难的特定危险因素,并且在一部分患者中,acss后的吞咽困难不是短暂的。本研究旨在评估ACSS后吞咽困难的影响,探讨其发生的潜在危险因素,评估用于诊断吞咽困难的方法,检查相关的转诊模式,并探讨ACSS后语言病理服务的使用情况。方法:本回顾性研究使用来自三级学术医疗中心的acss后患者6个月的数据。记录患者的社会人口学、手术和临床信息以及吞咽困难的诊断。评估acss后吞咽困难的危险因素、使用的诊断方式、并发症和转诊模式。结果:106例acss术后患者中,17例(16%)诊断为吞咽困难。术前吞咽困难是acss术后吞咽困难的唯一显著危险因素(OR = 8.705)。术后吞咽困难患者的并发症发生率明显较高,包括胃造口管放置(p < 0.001)、呼吸道感染(p < 0.001)、30天再入院率(p < 0.001)和死亡率(p = 0.004)。有症状的患者100%作为住院患者接受评估,但只有50%的时间作为门诊患者接受评估。此外,只有31.4%的有症状的吞咽困难患者进行了客观的吞咽评估。结论:在我们的acss后队列中,与文献相比,我们发现诊断为吞咽困难的患者发生率相对较低(16%)。我们还发现了科学知识与临床实践之间的差距,这可以通过缺乏吞咽困难的术前和术后筛查,器械吞咽检查的使用相对较低,以及acss后门诊临床吞咽评估的转诊率较低来证明。我们希望这项工作的发现能促使其他人评估与接受ACSS患者相关的临床实践模式,并为重点质量改进项目提供信息。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
American Journal of Speech-Language Pathology
American Journal of Speech-Language Pathology AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY-REHABILITATION
CiteScore
4.30
自引率
11.50%
发文量
353
审稿时长
>12 weeks
期刊介绍: Mission: AJSLP publishes peer-reviewed research and other scholarly articles on all aspects of clinical practice in speech-language pathology. The journal is an international outlet for clinical research pertaining to screening, detection, diagnosis, management, and outcomes of communication and swallowing disorders across the lifespan as well as the etiologies and characteristics of these disorders. Because of its clinical orientation, the journal disseminates research findings applicable to diverse aspects of clinical practice in speech-language pathology. AJSLP seeks to advance evidence-based practice by disseminating the results of new studies as well as providing a forum for critical reviews and meta-analyses of previously published work. Scope: The broad field of speech-language pathology, including aphasia; apraxia of speech and childhood apraxia of speech; aural rehabilitation; augmentative and alternative communication; cognitive impairment; craniofacial disorders; dysarthria; fluency disorders; language disorders in children; speech sound disorders; swallowing, dysphagia, and feeding disorders; and voice disorders.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信