What is the prognosis of dysphagia-related malnutrition?

Updated: Mar 20, 2020
  • Author: Nam-Jong Paik, MD, PhD; Chief Editor: Elizabeth A Moberg-Wolff, MD  more...
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Answer

Patients who have had a stroke are likely to decrease their dietary intake, which increases their risk of malnutrition or exacerbates existing malnourishment. [32] In an investigation of the nutritional status of patients with stroke who were admitted to a rehabilitation service, 49% had malnutrition, and 65% of those with dysphagia were malnourished. [33]

In another study, no differences were found in the nutritional parameters of patients admitted for stroke with or without dysphagia on admission. However, after 1 week, 48.3% of the patients with dysphagia were malnourished, compared with only 13.6% of those without dysphagia.

Malnutrition is a risk factor for pneumonia because it renders the person susceptible to altered colonization in the oropharynx and reduced resistance to infection by depressing the immune system. Malnutrition may also lead to lethargy, weakness, and reduced alertness, all of which may increase the probability of aspiration. In addition, malnutrition may reduce the strength of cough and mechanical clearance in the lungs.

A study by Gourin et al indicated that dysphagia-associated malnutrition is a significant risk factor for health outcomes in patients with head and neck cancer. In a study of 93,663 patients treated with ablative therapy for malignant neoplasms of the oral cavity, larynx, hypopharynx, or oropharynx, the investigators found that dysphagia was the most significant of several factors related to weight loss in these patients. The study also indicated that an association exists between weight loss and increases in medical and surgical complications, as well as in length of hospital stay and hospital-related costs, in patients who undergo head and neck cancer surgery. [34]


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