Incidence and factors associated with dysphagia in intensive care unit patients 24 h after extubation.

Background: Post‐extubation dysphagia deserves attention because it places patients at risk following extubation, especially critically ill patients in intensive care unit. However, there are limited studies of post‐extubation dysphagia in the early stages after extubation. Aim: To investigate the incidence and factors associated with post‐extubation dysphagia among patients in intensive care unit within 24 h of extubation. Study Design: A prospective descriptive study was carried out with 173 adult patients in intensive care unit with tracheal extubation at a tertiary hospital in Guangzhou, China. The Gugging Swallowing Screen was used to evaluate the swallowing function of patients 1, 4 and 24 h after extubation. Demographic and clinical data were retrieved from medical records. Results: The incidence of post‐extubation dysphagia in patients within 1, 4 and 24 h after extubation was 86.71% (n = 150), 63.01% (n = 109) and 43.35% (n = 75), respectively. The risk factors included older age (OR = 1.057, 95%CI [1.039, 1.072], p <.001), cardiovascular disease (OR = 0.098, 95%CI [0.082, 0.127], p =.012), thyroid dysfunction (OR = 5.042, 95%CI [1.527, 13.684], p <.001), non‐post‐operative admission (OR = 3.186, 95%CI [1.142, 14.422], p =.036), mechanical ventilation duration >48 h (OR = 3.558, 95%CI [1.217, 10.385], p =.020), intubation duration >24 h (OR = 0.533, 95%CI [0.278, 0.898], p =.048) and intubation model size ≤7 (OR = 0.327, 95%CI [0.158, 0.788], p <.01). Conclusions: This study revealed a high incidence of post‐extubation dysphagia in critical patients in the 24 h after extubation, with the incidence decreasing over time. Screening of early post‐extubation dysphagia after extubation is needed, but the specific evaluation time point requires further investigation. Patients with older age, cerebrovascular disease, thyroid dysfunction, post‐operative admission, longer mechanical ventilation time, thicker intubation models and longer intubation time have a higher risk of the occurrence of post‐extubation dysphagia. Relevance to Clinical Practice: The incidence of post‐extubation dysphagia is very high in the early stage. Within 24 h after extubation, the patient's swallowing function should be actively evaluated, and the occurrence of aspiration should be vigilant. Patients with older age, cerebrovascular disease, thyroid dysfunction, post‐operative admission, longer mechanical ventilation time, thicker intubation models and longer intubation time should receive more attention. [ABSTRACT FROM AUTHOR]