Factors associated with oropharyngeal dysphagia 3 months after ICU discharge in patients undergoing invasive mechanical ventilation: A post-hoc analysis of a Brazilian multicenter prospective cohort study.

PURPOSE: To evaluate the incidence and factors associated with oropharyngeal dysphagia (OD) three months after intensive care unit (ICU) discharge in patients who underwent invasive mechanical ventilation (IMV).

METHODS

This was a post-hoc analysis of a prospective multicenter cohort study conducted across ten clinical-surgical ICUs in Brazil. Adult survivors (age > 18 years) with ICU stays ≥72 h and who needed IMV were included. The primary outcome was the incidence of OD, assessed by the Functional Oral Intake Scale (FOIS) during structured telephone interviews. Secondary outcomes included quality of life, measured by the Short Form Health Survey version 2, and rehospitalization.

RESULTS

Among 360 patients, the incidence of OD 3 months after ICU discharge was 24.17%. Educational attainment (adjusted risk ratio [aRR] per 1 year increase, 0.95; 95% confidence interval [CI] 0.92-0.99), risk of death at ICU admission (aRR per 1% increase, 1.99; 95% CI, 1.06-3.77), acute respiratory distress syndrome [ARDS] diagnosis at ICU admission (aRR, 0.21; 95% CI, 0.06-0.71), and length of mechanical ventilation (aRR per 1 day increase, 1.02; 95%CI, 1.01-1.03) were associated with OD. Patients with OD reported significantly worse physical and mental quality-of-life scores. The incidence of rehospitalization did not differ significantly between patients with and without OD.

CONCLUSIONS

OD 3 months after ICU discharge is a common condition among ICU survivors who required IMV. Educational level, severity of illness at ICU admission, ARDS diagnosis at ICU admission, and length of mechanical ventilation are key associated variables.