Background Dysphagia has been reported in almost half of hospital patients who are over 65 years.1 In 2023 a Flexible Endoscopic Evaluation of Swallowing (FEES) service was introduced into the hospital. The purpose of this study was to profile the patients who were referred for FEES and determine the prevalence and severity of dysphagia. Methods Information on patient diagnosis, dysphagia related clinical outcome measures and waiting times when compared to Videofluoroscopy referral were collected from 30 patients who attended for FEES assessment in a rehabilitation hospital from August 2023 - May 2024. Results 97% of the patients who engaged in FEES were above the age of 65. Patients presented with a range of diagnoses including frailty (20%), progressive neurological conditions (18%), other (16.6%), stroke (13.3%), Chronic Obstructive Pulmonary Disease (13.3%), Acquired Brain Injury (3%), Gastroenterology (3%), and surgical (3%). Dysphagia was identified in 97% of patients, with 60% presenting within the moderate to severe range on the Australian Therapy Outcome Measures. 33% of patients presented with silent aspiration, with a third of these patients presenting as clinically asymptomatic. Following FEES evaluation, 40% of patients were recommended a change in diet texture or fluid consistency, with 54% and 70% of these patients being recommended a downgrade in diet or fluids respectively. The service has allowed for more timely access to instrumental swallow assessment with completion of FEES within an average of 4 days compared to referral for Videofluoroscopy; 24 days average. Conclusion This study has enabled us to profile patients accessing FEES. FEES facilitates quicker access to instrumental swallow assessment and identification of aspiration. It has also enabled targeted person centered dysphagia rehab. Reference 1. Doan, T.N et al (2022) Prevalence and methods for assessment of oropharyngeal dysphagia in older adults: a systematic review and meta-analysis. Journal of Clinical Medicine, 11(9), p.2605.

中文翻译：

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康复医院现场灵活内窥镜吞咽服务评估患者的临床、患者和服务结果


背景 据报道，近一半 65 岁以上的医院患者存在吞咽困难。1 2023 年，医院引入了灵活内窥镜吞咽评估 (FEES) 服务。本研究的目的是对转诊接受 FEES 的患者进行概况分析，并确定吞咽困难的患病率和严重程度。方法 从 2023 年 8 月至 2024 年 5 月期间在康复医院参加 FEES 评估的 30 名患者中收集了患者诊断、吞咽困难相关临床结果测量以及与视频透视转诊相比的等待时间的信息。结果 97% 的患者参与了 FEES年龄超过 65 岁。患者提出一系列诊断，包括虚弱 (20%)、进行性神经系统疾病 (18%)、其他 (16.6%)、中风 (13.3%)、慢性阻塞性肺疾病 (13.3%)、获得性脑损伤 (3%)、胃肠病学 (3%) 和外科手术 (3%)。 97% 的患者出现吞咽困难，其中 60% 的患者在澳大利亚治疗结果衡量标准中处于中度至重度范围内。 33% 的患者出现无声误吸症状，其中三分之一的患者没有临床症状。 FEES 评估后，40% 的患者被建议改变饮食质地或液体浓度，其中 54% 和 70% 的患者分别被建议降低饮食或液体浓度。与转诊视频荧光检查相比，该服务可以更及时地进行仪器吞咽评估，平均在 4 天内完成费用；平均24天。结论 这项研究使我们能够对使用 FEES 的患者进行分析。 FEES 有助于更快地获得仪器吞咽评估和误吸识别。 它还实现了以有针对性的人为中心的吞咽困难康复。参考文献 1. Doan, TN 等人 (2022) 老年人口咽吞咽困难的患病率和评估方法：系统评价和荟萃分析。临床医学杂志，11(9)，第 2605 页。