Disclosures: Joanna N. Israel, DO, MBS: No financial relationships or conflicts of interest

Objective: The purpose of this study is to examine the efficacy of screening for dysphagia in post-operative hip fracture patients with American Society of Anesthesia (ASA) scores of III or IV. Results from prior studies showed an ASA score of III and IV were meaningful predictors of dysphagia. This descriptive study quantifies the incidence of dysphagia diagnosed by speech language pathology (SLP) and development of pulmonary complications.

Design: Retrospective Study Setting : Inpatient Rehabilitation Facility Participants : 62 post-operative hip fracture patients

Interventions: SLP evaluation on post-operative hip fracture patients with an ASA score of III or IV

Main Outcome Measures: The incidence of pneumonia shown on radiographic imaging

Results: The incidence of dysphagia on SLP evaluation was found to be equal, approximately 21%, between the pre-intervention and intervention groups. The number of positive chest radiography findings in the intervention group decreased by 10.5% when compared to the pre-intervention group, however statistical significance was not appreciated. Conclusions: Dysphagia found on SLP evaluation was similar in the pre-intervention and intervention groups demonstrating an equal incidence of dysphagia. If patients were screened as indicated by ASA score the rate of dysphagia may be higher in the pre-intervention group. The primary outcome measure showed a decrease in the number of pulmonary complications in the intervention group demonstrating the efficacy of screening with SLP evaluation. Statistical significance was not appreciated but this finding may be considered clinically significant. Identifying dysphagia through prophylactic SLP evaluations on ‘high risk’ hip fracture patients allows the physician the ability to intervene promptly and potentially prevent pneumonia, therefore decreasing cost and maintaining patient safety. Further studies should be completed to include a larger sample size with multi-center data collection to prove prophylactic SLP evaluation as statistically significant. In the meantime, screening should be considered for post-operative hip fracture patients with an ASA of III or IV.

Level of Evidence: Level III

« Back to AAPM&R Annual Assembly 2020

PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/efficacy-of-screening-hip-fracture-patients-for-dysphagia-using-the-american-society-of-anesthesia-classification-system-scores/