P443 - TRAJECTORY OF POST-EXTUBATION DYSPHAGIA: FROM VENTILATOR WEANING TO HOSPITAL DISCHARGE

P443

TRAJECTORY OF POST-EXTUBATION DYSPHAGIA: FROM VENTILATOR WEANING TO HOSPITAL DISCHARGE

V. A. Fugas^1,2,3,*, P. Astegiano^1,2,3, M. D. Vago^2,3,4, M. V. Malachevsky^1,3, J. I. Barion^1,3

¹Unidad de Soporte Nutricional, ²Unidad de Terapia Intensiva, ³Equipo Interdisciplinario de Disfagia, ⁴Servicio de Fonoaudiología, Hospital Dr. J.M. Cullen, Santa Fe, Argentina

Rationale: Although post-extubation dysphagia is frequent in critically ill patients, its evolution from ICU to hospital discharge remains poorly explored. Understanding its course and associated factors is essential to optimize patient care, including nutritional therapy.

Methods: Preliminary data from a prospective study in a public tertiary hospital in Argentina (June 2024–February 2025) including 56 patients aged ≥18 years who required ≥48h of mechanical ventilation. Swallowing was assessed by an experienced speech-language pathologist using the Gugging Swallowing Screen-ICU (GUSS-ICU) at three time points: post-extubation, ICU discharge, and hospital discharge. Dysphagia was defined as a GUSS-ICU score <10. Kaplan-Meier survival analysis and Cox regression were used to assess dysphagia trajectories and swallowing recovery. Eight patients were censored: four died, two were discharged without assessment due to clinical conditions, and two did not recover swallowing function at discharge.

Results: Of 56 patients, 51 were assessed at ICU discharge and 50 at hospital discharge. Dysphagia prevalence decreased from 75% post-extubation to 43% at ICU discharge and 4% at hospital discharge. Swallowing function improved significantly over time (p<0.001, Cochran’s Q test). Pairwise comparisons showed significant differences at all transitions (p≤0.005, McNemar test with Bonferroni correction). A prolonged ICU stay was associated with lower odds of swallowing function recovery (HR=0.898; 95% CI: 0.833–0.967; p=0.005).

Conclusion: Most patients had dysphagia after extubation. Although it significantly improved by hospital discharge, nearly half of the patients in general wards still had it. Early, systematic assessment is key to guiding appropriate care throughout hospitalization, especially for those with prolonged ICU stays, given its impact on swallowing function recovery.

Disclosure of Interest: None declared