Post-Extubated Dysphagia in Intensive Care Unit Patients Based on Flexible Endoscopic Evaluation of Swallowing Examination and Its Affecting Factors
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Background and Objectives Post-extubation dysphagia (PED) is a condition characterizedby swallowing difficulty following the removal of breathing tube. Untreated dysphagia leadsto increased morbidity and mortality; however, no study has been conducted on the proportionof PED at RSUPN Dr. Cipto Mangunkusumo (RSCM), using flexible endoscopic evaluationof swallowing (FEES), or on the factors that contribute to its occurrence. Subjects and Method Anamnesis and medical record review were conducted on post-extu-bation patients in the RSCM intensive care unit (ICU) meeting inclusion criteria. Researchsubjects underwent maximum phonation time (MPT) examination thrice. FEES examinationwas carried out twice, with 24 hours of post-extubation on all subjects and 72 hours of post-extubation on those with PED on initial FEES examination. Results The study involved 33 subjects who met the inclusion criteria. The proportion ofmild to severe PED determined by FEES 24 hours after extubation was 66.7%, and those ex-hibiting laryngeal injury was 87.9%. The bivariate analysis revealed a significant correlationbetween the number of comorbidities, intubation duration, laryngeal injury severity, and MPTvalue with the incidence of PED in the RSCM ICU. Moreover, the multivariate analysisshowed that the duration of intubation exceeding 24 hours had a statistically significant asso-ciation with the incidence of PED ( p=0.003; OR 15.30; 95% CI 2.46-95.19). Conclusion The proportion of mild to severe dysphagia in post-extubation patients in theRSCM ICU is quite high. Intubation duration exceeding 24 hours and having more than onecomorbidity significantly contribute to the increased risk of dysphagia in post-extubated pa-tients in the RSCM ICU.
Abstract
Background and Objectives Post-extubation dysphagia (PED) is a condition characterizedby swallowing difficulty following the removal of breathing tube. Untreated dysphagia leadsto increased morbidity and mortality; however, no study has been conducted on the proportionof PED at RSUPN Dr. Cipto Mangunkusumo (RSCM), using flexible endoscopic evaluationof swallowing (FEES), or on the factors that contribute to its occurrence. Subjects and Method Anamnesis and medical record review were conducted on post-extu-bation patients in the RSCM intensive care unit (ICU) meeting inclusion criteria. Researchsubjects underwent maximum phonation time (MPT) examination thrice. FEES examinationwas carried out twice, with 24 hours of post-extubation on all subjects and 72 hours of post-extubation on those with PED on initial FEES examination. Results The study involved 33 subjects who met the inclusion criteria. The proportion ofmild to severe PED determined by FEES 24 hours after extubation was 66.7%, and those ex-hibiting laryngeal injury was 87.9%. The bivariate analysis revealed a significant correlationbetween the number of comorbidities, intubation duration, laryngeal injury severity, and MPTvalue with the incidence of PED in the RSCM ICU. Moreover, the multivariate analysisshowed that the duration of intubation exceeding 24 hours had a statistically significant asso-ciation with the incidence of PED ( p=0.003; OR 15.30; 95% CI 2.46-95.19). Conclusion The proportion of mild to severe dysphagia in post-extubation patients in theRSCM ICU is quite high. Intubation duration exceeding 24 hours and having more than onecomorbidity significantly contribute to the increased risk of dysphagia in post-extubated pa-tients in the RSCM ICU.
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