Investigation of inhibiting factors of dysphagia rehabilitation in cardiovascular patients treated with invasive and non-invasive mechanical ventilation

Abstract

Abstract Objectives To clarify the factors inhibiting dysphagia rehabilitation in cardiovascular patients treated with invasive and non-invasive mechanical ventilation (MV). Methods The subjects were patients with dysphagia and cardiovascular disease treated with MV who were admitted to our hospital between April 2019-December 2021. Age, sex, walking ability, Geriatric Nutritional Risk Index (GNRI), primary heart disease, Charlson Comorbidity Index (CCI), invasive or non-invasive MV, Sequential Organ Failure Assessment (SOFA) at the start of MV, duration of MV, days from the withdrawal of MV to the start of rehabilitation, Functional Oral Intake Scale (FOIS) at the start of rehabilitation and discharge, length of hospital stay, pneumonia after the start of rehabilitation, and death during hospitalization were retrospectively surveyed. Results Ninety-six of the 105 patients survived, and 37 patients recovered from dysphagia. Twenty-two patients needed alternative nutrition at the start of rehabilitation, which was significantly associated with the duration of MV, length of hospital stay, and pneumonia after the start of rehabilitation. Death during hospitalization was significantly associated with lower GNRI scores, a history of chronic pulmonary disease, lower FOIS scores at the start of rehabilitation, and pneumonia developed during hospitalization. Dysphagia at discharge was significantly associated with older age, walking disability, lower GNRI scores, congestive heart failure, higher CCI scores, non-invasive MV, and higher SOFA scores. Conclusions The factors inhibiting dysphagia rehabilitation in cardiovascular patients treated with MV differed between the initial evaluation and outcomes and between vital and functional outcomes. Nutritional risk is a common risk factor for vital and functional outcomes.