Severe dysphagia reflects poor outlook in patients with acute HF exacerbation

The presence of dysphagia may independently predict clinical outcomes in patients with acute exacerbation of heart failure (HF), such that the more severe the condition, the higher the in-hospital mortality and the longer the length of hospital stay, as reported in a study.

The study included 327 HF inpatients. Researchers evaluated dysphagia severity (Functional Oral Intake Scale [FOIS]), cognitive function (Mini-Mental State Exam [MMSE]), handgrip strength, exercise tolerance, nutritional status (albumin, transthyretin, and Controlling Nutritional Status [CONUT]) and activities of daily living (Barthel Index [BI]) at admission.

Of the patients, 288 were discharged. Compared with those without dysphagia (controls), patients with the condition were older and had higher N-terminal pro B-type natriuretic peptide and CONUT scores. The presence of dysphagia was also associated with substantially lower serum levels of albumin and transthyretin, MMSE, exercise tolerance, muscle strength, and BI.

Furthermore, outcomes were less favourable in the dysphagia vs the control group. Specifically, mortality rate was higher (15.0 percent vs 3.2 percent), length of hospital stay was longer (36.1 vs 29.3 days), and the ratio of discharge to home was lower (56.6 percent vs 83.9 percent).

Significant factors associated with outcomes were as follows: FOIS and transthyretin for in-hospital mortality; FOIS, MMSE and BI for length of hospital stay; and FOIS, age, MMSE and handgrip strength for discharge to home.