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Abstract
Objectives Fibre-endoscopic evaluation of swallowing (FEES) to detect dysphagia is gaining more and more importance as a diagnostic tool. Therefore, we have investigated the impact of FEES in neurological patients in a clinical setting.
Design Cross-sectional hospital-based registry.
Setting Primary acute care in a neurological department of a German university hospital.
Participants 241patients with various neurological diseases who underwent FEES procedure.
Primary and secondary outcome measures Dysphagia and related comorbidities.
Results 267 FEES were performed in 241 patients with various neurological diagnoses. Dysphagia was diagnosed in 68.9% of the patients. In only 33.1% of the patients, appropriate oral diet was chosen prior to FEES. A relevant dysphagia occurred more often in patients with structural brain lesions (83.1% vs 65.3%, P=0.001), patients with dysphagia had a longer hospitalisation (median 18 (IQR 12–30) vs 15 days (IQR 9.75–22.75), P=0.005) and had a higher mortality (8.4% vs 1.3%, P=0.041). When the oral diet was changed, we observed a lower pneumonia rate (36% vs 50%, P=0.051) and a lower mortality (3.7% vs 11.3%, P=0.043) in comparison to no change of oral diet. A restriction of oral diet was identified more often in older patients (median 75 years (IQR 66.3–82 years) vs median 72 years (IQR 60–79 years), P=0.01) and in patients with structural brain lesions (86.8% vs 73.1%, P=0.05).
Conclusion On clinical investigation, dysphagia was misjudged for the majority of the patients. FEES might help to compensate this drawback, revising the diet regime in nearly 70% of the patients.
- dysphagia
- endoscopy
- adult neurology
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Footnotes
Contributors TB, MJ, MK and CT: Conceptualisation. TB, MV, MM and IR: FEES examinations. TB, MJ and MP: Analysis of data and statistics. TB and CT: Preparation of original draft. All authors: Review and editing; ICMJE criteria for authorship read and agree with manuscript results and conclusions.
Funding This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Patient consent Not required.
Ethics approval For the data acquisition and their use for scientific analyses, an ethical approval was obtained from the local ethical committee (Justus-Liebig University, protocol number 208/16).
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement The authors declare that the data supporting the findings of this study are available within the article. The data that support the findings of this study are not publically available due to local medical data protection policies.