SURVIVAL ESTIMATES FOR PATIENTS WITH ABNORMAL SWALLOWING STUDIES

OBJECTIVE: To better understand the life expectancy of patients who ha ve an abnormal videofluoroscopic swallowing study. DESIGN: Retrospecti ve cohort study. The common starting point was the time of the severel y abnormal swallowing study. Hospital charts were reviewed for clinica l variables of potential prognostic significance by reviewers blinded to the outcome of interest, survival time. SETTING: A university-affil iated, community teaching hospital. PATIENTS: One hundred forty-cine h ospitalized patients who were deemed nonoral feeders based on their sw allowing study, Patients excluded were those with head, neck, or esoph ageal cancer, or those undergoing a thoracotomy procedure. MEASUREMENT S AND MAIN RESULTS: Clinical and demographic variables and time until death or censoring were measured, Overall I-year mortality was 62%. Mu ltivariable Cox proportional hazards analyses identified four variable s that independently predicted death: advanced age, reduced serum albu min concentration, disorientation to person, and higher Charlson comor bidity score, Eighty patients (54%) subsequently underwent placement o f a percutaneous endoscopic gastrostomy (PEG) tube after their swallow ing study. CONCLUSIONS: Mortality is high in patients with severely ab normal swallowing studies, Common clinical variables can be used to id entify groups of patients with particularly poor prognoses. This infor mation may help guide discussions regarding possible PEG placement.