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Identifier 000447900
Title Η λειτουργικότητα του μηχανισμού κατάποσης σε μετεγχειρητικούς ασθενείς
Alternative Title The functionality of the swallowing mechanism in postoperative patients
Author Τζωρτζάκης, Ιωάννης
Thesis advisor Ηλία, Σταυρούλα
Reviewer Παπαϊωάννου, Αλεξάνδρα
Μπριασούλης, Γεώργιος
Abstract Introduction: Eating and swallowing disorders describe any malfunction or difficulty in feeding / swallowing. They affect a wide range of ages from infancy to old age. Dysphagia is not presented as a separate disease but as a complex of symptoms that appear in the light of more general pathology. Dysphagia following intubation is in itself a risk factor for the patient's outcome. Early identification and management of patients with dysphagia are vital to reduce adverse outcomes for the patient as well as the cost of his health care. Aim: The purpose of this retrospective study was to investigate the impact and risk factors for four-stage swallowing disorders in postoperative patients at Heraklion University Hospital, who were endotracheally intubated. Methods: Patients with the following criteria were included: surgery> 1 hour regardless of age who were intubated during surgery. Patients who have not been endotracheally intubated or have impaired neurological status (Glasgow Coma Scale <14), diagnosed swallowing disorders, laryngeal tumors, esophageal achalasia, and brain tumor were excluded. As a first step in the assessment process, and the day after the end of the patient's operation, a detailed history was taken and recorded in the study registration form. The Mann Assessment of Swallowing Ability (MASA) clinical tool was used to control swallowing dysfunction. Results: A total of 80 patients from the Anesthesiology Clinic were included in the study. The mean age of patients was 56.7 ± 18 years, women 25 (31.3%). The risk of dysphagia was probable in 13.8%, very probable in 17.5%, while almost unlikely in 68.8% of patients examined with a MASA score. The risk index for dysphagia and aspiration did not differ between patients who had 1 or more intubation attempts. The mean duration of intratracheal intubation was 4.3 ± 1 hours, and the risk did not increase with longer intubation and was not affected by patient age or other clinical parameters. Patients with tracheostomy had a higher relative risk of failure (p = 0.069) of the MASA test, while the Malampati score did not significantly increase the risk of dysphagia. Patients who had a nasogastric tube had an increased risk of developing dysphagia. In ROC analysis, age, intubation efforts, duration of mechanical ventilation, presence of tracheostomy, SpO2 and various somatometric data of patients did not show strong prognostic indicators in this group of postoperative patients. Conclusions: The present study studied the effects of the risk of dysphagia in postoperative patients with endotracheal intubation. Short-term intubation, difficult airway, and the number of intubation attempts were not associated with swallowing disorders. Patients who had a nasogastric tube had an increased risk of developing dysphagia. The risk of dysphagia in postoperative patients was significantly associated with the MASA score (high risk - low score
Language Greek
Subject Airway
Dysphagia
Intubation
MASA
Αεραγωγός
Διασωλήνωση
Δυσφαγία
Issue date 2022-03-30
Collection   School/Department--School of Medicine--Department of Medicine--Post-graduate theses
  Type of Work--Post-graduate theses
Permanent Link https://elocus.lib.uoc.gr//dlib/7/3/4/metadata-dlib-1651829927-943873-6266.tkl Bookmark and Share
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