Healthcare costs of post-stroke oropharyngeal dysphagia and its complications : malnutrition and respiratory infections
Marin, Sergio (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Serra-Prat, Mateu (Hospital de Mataró. Consorci Sanitari del Maresme)
Ortega, Omar (Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas)
Audouard Fericgla, Monica (Hospital Universitari Dexeus (Barcelona, Catalunya))
Valls, Jordi (Hospital de Mataró. Consorci Sanitari del Maresme)
Palomera, Elisabet (Hospital de Mataró. Consorci Sanitari del Maresme)
Cunillera, Ramon (Hospital de Mataró. Consorci Sanitari del Maresme)
Palomeras, Ernest (Hospital de Mataró. Consorci Sanitari del Maresme)
Ibàñez, Josep Maria (Hospital de Mataró. Consorci Sanitari del Maresme)
Clavé i Civit, Pere (Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas)

Data:	2021
Resum:	Background and purpose: The healthcare economic costs of post-stroke oropharyngeal dysphagia (OD) are not fully understood. The purpose of this study was to assess the acute, subacute and long-term costs related to post-stroke OD and its main complications (malnutrition and respiratory infections). Methods: A cost of illness study of patients admitted to Mataró Hospital (Catalonia, Spain) from May 2010 to September 2014 with a stroke diagnosis was performed. OD, malnutrition and respiratory infections were assessed during hospitalization and follow-up (3 and 12 months). Hospitalization and long-term costs were measured from hospital and healthcare system perspectives. Multivariate linear regression analysis was performed to assess the independent effect of OD, malnutrition and respiratory infections on healthcare costs during hospitalization, and at 3 and 12 months' follow-up. Results: In all, 395 patients were included of whom 178 had OD at admission. Patients with OD incurred major total in-hospital costs (€5357. 67 ± €3391. 62 vs. €3976. 30 ± €1992. 58, p < 0. 0001), 3-month costs (€8242. 0 ± €5376. 0 vs. €5320. 0 ± €4053. 0, p < 0. 0001) and 12-month costs (€11,617. 58 ± €12,033. 58 vs. €7242. 78 ± €7402. 55, p < 0. 0001). OD was independently associated with a cost increase of €789. 68 (p = 0. 011) during hospitalization and of €873. 5 (p = 0. 084) at 3 months but not at 12 months. However, patients with OD who were at risk of malnutrition or malnourished and suffered respiratory infections incurred major mean costs compared with those patients without OD (€19,817. 58 ± €13,724. 83 vs. €7242. 8 ± €7402. 6, p < 0. 0004) at 12 months' follow-up. Conclusion: Oropharyngeal dysphagia causes significant high economic costs during hospitalization that strongly and significantly increase with the development of malnutrition and respiratory infections at long-term follow-up.
Nota:	Altres ajuts: acords transformatius de la UAB
Nota:	Financial support received from research grants from Nutricia Danone Advanced Medical Nutrition (HESDY Grant); Fundació Salut del CSdM, Strategic Action Grant in Oropharyngeal Dysphagia provided by the Centro de Investigación Biomédica en Red en el Área de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, DJO Global, and la Fundació la Marató de TV3 (11/2310).
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, i la comunicació pública de l'obra, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Deglutition disorders ; Economics ; Malnutrition ; Respiratory tract infections ; Stroke
Publicat a:	European Journal of Neurology, Vol. 28 No. 11 (2021) , p. 3670-3681, ISSN 1468-1331

DOI: 10.1111/ene.14998

14 p, 1.8 MB

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Documents de recerca > Documents dels grups de recerca de la UAB > Centres i grups de recerca (producció científica) > Ciències de la salut i biociències > Institut d'Investigació en Ciencies de la Salut Germans Trias i Pujol (IGTP)
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