Swallowing problems affect 1 in 3 hospitalized ALS patients: Study
Group had greater risk of complications, higher healthcare costs
Written by |
- One-third of hospitalized ALS patients experience dysphagia (swallowing issues).
- Dysphagia leads to longer hospital stays, higher costs, and complications.
- Early screening and interventions can improve care for ALS patients.
Swallowing difficulties are a common challenge for people with amyotrophic lateral sclerosis (ALS) and may place a substantial burden on patients during hospital stays, according to an analysis of a large U.S. database.
The study found that about one-third of hospitalized ALS patients experienced difficulty swallowing (dysphagia), and these patients had longer hospital stays, higher healthcare costs, and a greater risk of complications.
The findings highlight the importance of identifying and managing swallowing problems early, with researchers noting that “timely screening and tailored interventions” could help reduce complications and improve care.
The study, “Prevalence and Risk Factors of Dysphagia in Amyotrophic Lateral Sclerosis: A Retrospective Study Using the Nationwide Inpatient Sample Database,” was published in the journal Muscle & Nerve.
Most ALS patients experience some degree of swallowing difficulty
Because ALS causes progressive muscle weakness, it can affect the muscles that control swallowing. Most people with ALS will experience some degree of swallowing difficulty at some point in their disease course.
When this happens, patients may struggle to maintain proper nutrition and hydration. Food or liquid can also enter the lungs, which can lead to a potentially life-threatening complication known as aspiration pneumonia. Swallowing issues can also affect a person’s well-being by preventing them from savoring food and from participating in social activities centered around meals.
Despite its frequency and impact, large-scale studies examining how dysphagia affects hospital outcomes and which factors may increase the risk of dysphagia have been limited.
To learn more, a group of researchers in China examined records from the U.S. National Inpatient Sample database, looking at nearly 24,000 ALS patients who were hospitalized between 2010 and 2019. Among these, about 31.7% had dysphagia.
Most hospital admissions were for reasons other than swallowing problems, with only 4.6% of hospital admissions being primarily for urgent dysphagia management.
Still, swallowing issues had clear negative consequences. Patients with dysphagia stayed in the hospital longer — a median of five days, compared with four days for those without swallowing difficulties — and incurred $6,656 in additional hospital charges.
Patients were also significantly older (median 66 vs. 64 years), were more often treated in teaching hospitals, and were less likely to be admitted electively (i.e., scheduled hospital admission).
Older age, female sex associated with increased likelihood of dysphagia
The researchers then conducted a multivariate analysis to find potential risk factors for dysphagia. It showed that older age, female sex, Hispanic ethnicity, and being treated in large, teaching, or urban hospitals were all associated with an increased likelihood of dysphagia. In contrast, Black race was protective against dysphagia.
Dysphagia was also significantly associated with other clinical conditions, “highlighting its broad clinical burden in ALS,” the researchers wrote.
These conditions included cognitive impairment, stroke, malnutrition, anxiety disorders, pseudobulbar palsy (weakness of the muscles that control speech and swallowing), respiratory muscle paralysis, tracheostomy (a surgically created opening in the neck to help with breathing), and osteoporosis (weakened bones).
In-hospital death rates were slightly lower among patients with dysphagia.
Overall, the results reinforce that swallowing difficulties are common in ALS, “contributing to extended hospital stays and increased healthcare costs,” the researchers wrote.
By identifying patients at higher risk, the researchers say clinicians may be better positioned to intervene earlier — potentially reducing complications and improving outcomes for people living with the progressive disease.
Leave a comment
Fill in the required fields to post. Your email address will not be published.