Meta-analysis identifies prevalence and risk factors for postextubation dysphagia in ICU patients
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Key Takeaway
Note that factors such as advanced age, high APACHE II scores, and prolonged intubation are associated with increased risk.
This meta-analysis synthesized data from 7,219 patients in the intensive care unit to evaluate the prevalence of postextubation dysphagia and identify associated risk factors. The analysis focused on patients undergoing orotracheal intubation.
The pooled prevalence of postextubation dysphagia was 35% (95% CI: 25–46). The authors identified several factors associated with an increased risk of the condition. Age was positively associated with risk, specifically for patients aged 65 years (OR = 2.72) and 70 years (OR = 2.34). Higher APACHE II scores also showed an association, particularly for scores 15 points or greater (OR = 4.69). Other identified risk factors included arrhythmia (OR = 3.30), neurological disorders (OR = 3.77), and emergency admission (OR = 2.30).
Duration of tracheal intubation and gastric tube retention were also linked to increased risk. For every hour of intubation, the risk increased (OR = 1.03), as did every day of intubation (OR = 1.13). Specifically, intubation lasting 72 hours or more was associated with an increased risk (OR = 8.15), and durations of 7 days or more showed an increased risk (OR = 2.06). Gastric tube retention was associated with increased risk (OR = 6.59), particularly when retention lasted 72 hours or more (OR = 3.43).
Clinicians may use these identified risk factors to assist in the early identification of high-risk individuals to implement targeted preventive measures. The study reports associations rather than causal relationships.
View Original Abstract ↓
BackgroundEvidence suggests that 41% of ICU patients acquired postextubation dysphagia, substantially increasing the risk of aspiration and malnutrition. Studies on its prevalence and risk factors showed considerable variation. Our study aims to summarize the overall prevalence and identify risk factors for postextubation dysphagia in ICU patients undergoing orotracheal intubation.MethodsWe searched PubMed, Embase, Web of Science, Cochrane Library, CINAHL, Medline, China National Knowledge Infrastructure, Wanfang, SinoMed, and Technology Journal Database for studies on postextubation dysphagia from inception to July 5, 2025. Two researchers independently conducted the literature screening, quality assessment, and extracted data. Meta-analysis was performed using Stata software 18.0 and Review Manager software 5.3.ResultsTwenty-five studies were included, encompassing a total of 7,219 patients. The meta-analysis revealed that the overall prevalence of postextubation dysphagia was 35% (95% CI: 25–46). Age (OR = 1.03), age ≥ 65 years (OR = 2.72), age ≥ 70 years (OR = 2.34), Acute Physiology and Chronic Health Evaluation II (APACHE II) score (OR = 1.29), APACHE II score ≥ 15 points (OR = 4.69), arrhythmia (OR = 3.30), neurological disorders (OR = 3.77), tracheal intubation duration in hours (OR = 1.03), tracheal intubation duration in days (OR = 1.13), tracheal intubation duration ≥72 h (OR = 8.15), tracheal intubation duration ≥7 days (OR = 2.06), gastric tube retention (OR = 6.59), and gastric tube retention duration ≥72 h (OR = 3.43), emergency admission (OR = 2.30) were risk factors for postextubation dysphagia.ConclusionThe incidence of PED in ICU patients is relatively high, which is influenced by various factors. Based on the identified risk factors, clinical staff can early identify high-risk individuals and implement targeted preventive measures to avoid postextubation dysphagia.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/, CRD420251090144.
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