Dysphagia Incidence after Cardiac Surgery: a Meta-analysis

Background Dysphagia incidence after cardiac surgery is increasing due to increased complexity of the surgery and number of older patients, which has become one of the most severe complications of cardiac surgery, affecting patients' physical health and recovery. Objective To perform a revi...

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Main Author: LIU Lu, JIANG Yunlan, PENG Hanmei, LU Yutong, LIU Mingting, LIAO Shiqin
Format: Article
Language:zho
Published: Chinese General Practice Publishing House Co., Ltd 2023-06-01
Series:Zhongguo quanke yixue
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Online Access:https://www.chinagp.net/fileup/1007-9572/PDF/zx20220603.pdf
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author LIU Lu, JIANG Yunlan, PENG Hanmei, LU Yutong, LIU Mingting, LIAO Shiqin
author_facet LIU Lu, JIANG Yunlan, PENG Hanmei, LU Yutong, LIU Mingting, LIAO Shiqin
author_sort LIU Lu, JIANG Yunlan, PENG Hanmei, LU Yutong, LIU Mingting, LIAO Shiqin
collection DOAJ
description Background Dysphagia incidence after cardiac surgery is increasing due to increased complexity of the surgery and number of older patients, which has become one of the most severe complications of cardiac surgery, affecting patients' physical health and recovery. Objective To perform a review of available evidence on the incidence of dysphagia after cardiac surgery. Methods Databases of PubMed, Embase, Cochrane Library, CINAHL, Web of Science, CBM, CNKI, Wanfang Data, and VIP were searched from inception to May 2022 for published studies on the incidence of dysphagia after cardiac surgery. Two researchers independently conducted a literature enrollment, quality assessment, and data extraction. Meta-analysis was conducted using Stata 15.0. Results Fifteen studies with 7 880 patients were included. The meta-analysis revealed that the overall incidence of dysphagia after cardiac surgery was 13.3%〔95%CI (10.1%, 16.5%) 〕. Further region-specific analysis indicated that, the incidence of dysphagia following cardiac surgery in Asia, North America, and Oceania was 16.6%〔95%CI (10.4%, 22.8%) 〕, 10.0%〔95%CI (6.1%, 13.8%) 〕, and 17.4%〔95%CI (12.3%, 23.5%) 〕, respectively. According to sex-specific analysis, the incidence of dysphagia following cardiac surgery was 16.9%〔95%CI (11.8%, 21.9%) 〕, and 16.4%〔95%CI (11.1%, 21.8%) 〕 in male and female patients, respectively. The analysis based on age group indicated that the dysphagia incidence following cardiac surgery in patients aged <70 years and ≥70 years was 10.9%〔95%CI (8.6%, 13.5%) 〕 and 28.4%〔95%CI (19.7%, 37.9%) 〕, respectively. And analysis based on NYHA class found that the dysphagia incidence was 11.8%〔95%CI (7.4%, 16.3%) 〕 in patients with NYHA classⅠ or Ⅱ, and was 21.0%〔95%CI (11.0%, 30.9%) 〕 in those with NYHA class Ⅲ or Ⅳ. In accordance with analysis based on the duration of perioperative endotracheal intubation, the incidence of dysphagia following cardiac surgery in patients with <12 hours, 12-24 hours, 25-48 hours and >48 hours was 1.0%〔95%CI (0.3%, 1.8%) 〕, 6.4%〔95%CI (4.4%, 8.3%) 〕, 16.8%〔95%CI (9.5%, 24.1%) 〕, and 55.0%〔95%CI (28.0%, 82.0%) 〕, respectively. In addition, chronic kidney disease, chronic lung disease, previous history of cerebrovascular accident, atrial fibrillation, heart failure, intraoperative transesophageal echocardiography, perioperative stroke and sepsis were associated with a higher incidence of dysphagia after cardiac surgery. The results of the meta-analysis were robust, as shown by sensitivity analysis. Both Begg's and Egger's tests yielded P-value<0.05, indicating that publication bias existed in the studies. Conclusion Current evidence indicates that the incidence of dysphagia after cardiac surgery is high (13.3%), therefore, prompt postsurgical screening and treatment of dysphagia should be administered.
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spelling doaj.art-6ec9f74651074573b5800ef7242ac91b2024-04-09T08:05:17ZzhoChinese General Practice Publishing House Co., LtdZhongguo quanke yixue1007-95722023-06-0126182293230010.12114/j.issn.1007-9572.2022.0603Dysphagia Incidence after Cardiac Surgery: a Meta-analysisLIU Lu, JIANG Yunlan, PENG Hanmei, LU Yutong, LIU Mingting, LIAO Shiqin01. School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu 610072, China;2. Hospital of Chengdu University of TCM, Chengdu 610075, ChinaBackground Dysphagia incidence after cardiac surgery is increasing due to increased complexity of the surgery and number of older patients, which has become one of the most severe complications of cardiac surgery, affecting patients' physical health and recovery. Objective To perform a review of available evidence on the incidence of dysphagia after cardiac surgery. Methods Databases of PubMed, Embase, Cochrane Library, CINAHL, Web of Science, CBM, CNKI, Wanfang Data, and VIP were searched from inception to May 2022 for published studies on the incidence of dysphagia after cardiac surgery. Two researchers independently conducted a literature enrollment, quality assessment, and data extraction. Meta-analysis was conducted using Stata 15.0. Results Fifteen studies with 7 880 patients were included. The meta-analysis revealed that the overall incidence of dysphagia after cardiac surgery was 13.3%〔95%CI (10.1%, 16.5%) 〕. Further region-specific analysis indicated that, the incidence of dysphagia following cardiac surgery in Asia, North America, and Oceania was 16.6%〔95%CI (10.4%, 22.8%) 〕, 10.0%〔95%CI (6.1%, 13.8%) 〕, and 17.4%〔95%CI (12.3%, 23.5%) 〕, respectively. According to sex-specific analysis, the incidence of dysphagia following cardiac surgery was 16.9%〔95%CI (11.8%, 21.9%) 〕, and 16.4%〔95%CI (11.1%, 21.8%) 〕 in male and female patients, respectively. The analysis based on age group indicated that the dysphagia incidence following cardiac surgery in patients aged <70 years and ≥70 years was 10.9%〔95%CI (8.6%, 13.5%) 〕 and 28.4%〔95%CI (19.7%, 37.9%) 〕, respectively. And analysis based on NYHA class found that the dysphagia incidence was 11.8%〔95%CI (7.4%, 16.3%) 〕 in patients with NYHA classⅠ or Ⅱ, and was 21.0%〔95%CI (11.0%, 30.9%) 〕 in those with NYHA class Ⅲ or Ⅳ. In accordance with analysis based on the duration of perioperative endotracheal intubation, the incidence of dysphagia following cardiac surgery in patients with <12 hours, 12-24 hours, 25-48 hours and >48 hours was 1.0%〔95%CI (0.3%, 1.8%) 〕, 6.4%〔95%CI (4.4%, 8.3%) 〕, 16.8%〔95%CI (9.5%, 24.1%) 〕, and 55.0%〔95%CI (28.0%, 82.0%) 〕, respectively. In addition, chronic kidney disease, chronic lung disease, previous history of cerebrovascular accident, atrial fibrillation, heart failure, intraoperative transesophageal echocardiography, perioperative stroke and sepsis were associated with a higher incidence of dysphagia after cardiac surgery. The results of the meta-analysis were robust, as shown by sensitivity analysis. Both Begg's and Egger's tests yielded P-value<0.05, indicating that publication bias existed in the studies. Conclusion Current evidence indicates that the incidence of dysphagia after cardiac surgery is high (13.3%), therefore, prompt postsurgical screening and treatment of dysphagia should be administered.https://www.chinagp.net/fileup/1007-9572/PDF/zx20220603.pdfdeglutition disorders|cardiac surgical procedures|incidence|meta-analysis|case-control study|cohort study
spellingShingle LIU Lu, JIANG Yunlan, PENG Hanmei, LU Yutong, LIU Mingting, LIAO Shiqin
Dysphagia Incidence after Cardiac Surgery: a Meta-analysis
Zhongguo quanke yixue
deglutition disorders|cardiac surgical procedures|incidence|meta-analysis|case-control study|cohort study
title Dysphagia Incidence after Cardiac Surgery: a Meta-analysis
title_full Dysphagia Incidence after Cardiac Surgery: a Meta-analysis
title_fullStr Dysphagia Incidence after Cardiac Surgery: a Meta-analysis
title_full_unstemmed Dysphagia Incidence after Cardiac Surgery: a Meta-analysis
title_short Dysphagia Incidence after Cardiac Surgery: a Meta-analysis
title_sort dysphagia incidence after cardiac surgery a meta analysis
topic deglutition disorders|cardiac surgical procedures|incidence|meta-analysis|case-control study|cohort study
url https://www.chinagp.net/fileup/1007-9572/PDF/zx20220603.pdf
work_keys_str_mv AT liulujiangyunlanpenghanmeiluyutongliumingtingliaoshiqin dysphagiaincidenceaftercardiacsurgeryametaanalysis