Speech language pathology evaluation is associated with decreased mortality in hip fracture patients with dysphagia.

Abstract

Dysphagia is prevalent within the geriatric hip fracture population and can lead to postoperative complications such as malnutrition, aspiration, and mortality. This study evaluates the impact of speech language pathology (SLP) evaluations and dietary changes in this population and their impact on mortality. A retrospective cohort study including patients ≥ 65 years old who underwent surgical treatment for hip fracture from January 2015 to December 2020 at an academic level 1 tertiary center was completed. The rate of dysphagia and its association with mortality were noted. Outcome measurements included the rate of SLP evaluation, the rate of diet modifications, and the effect of these interventions on mortality risk in the cohort of patients with dysphagia. Within the cohort, 56% (347/617) patients had dysphagia, 29% (180/617) were on a dysphagia diet, and 44% (272/617) received a SLP evaluation. Of the patients with dysphagia, 46% (161/347) were on a dysphagia diet and 77% (266/347) received a SLP evaluation. Patients with dysphagia who received an SLP evaluation had lower mortality rates (7.1%) than those who did not have an SLP evaluation (15%) (OR 0.44, CI 0.21-0.96, p = 0.034). Patients with dysphagia who were on a dysphagia diet had no difference in mortality rates (OR 0.82, CI 0.39-1.7, p = 0.60) compared with those without a dysphagia diet. In this cohort, SLP evaluations for patients with dysphagia significantly reduced mortality, suggesting a role for routine early identification and intervention. This suggests that SLP evaluation and treatment improves outcomes, specifically mortality, in this population.