title: Duration of oral endotracheal intubation is associated with dysphagia symptoms in acute lung injury patients.
abstract: OBJECTIVE
  The purpose of this study is to evaluate demographic and clinical factors associated with self-reported dysphagia after oral endotracheal intubation and mechanical ventilation in patients with acute lung injury (ALI).
  
  
  METHODS
  This is a prospective cohort study of 132 ALI patients who had received mechanical ventilation via oral endotracheal tube.
  
  
  RESULTS
  The primary outcome was binary, whether clinically important symptoms of dysphagia at hospital discharge were reported by patients, using the Sydney Swallowing Questionnaire score 200 or more. Of 132 patients, 29% reported clinically important symptoms of dysphagia. Of 18 relevant demographic and clinical variables, only 2 were found to be independently associated with clinically important symptoms of dysphagia in a multivariable logistic regression model: upper gastrointestinal comorbidity (odds ratio, 2.82; 95% confidence interval, 1.09-7.26) and duration of oral endotracheal intubation (odds ratio, 1.79; [95% confidence interval, 1.15-2.79] per day for first 6 days, after which additional days of intubation were not associated with a further increase in the odds of dysphagia).
  
  
  CONCLUSIONS
  In ALI survivors, patient-reported, postexubation dysphagia at hospital discharge was significantly associated with upper gastrointestinal comorbidity and a longer duration of oral endotracheal intubation during the first 6 days of intubation.
authors.affiliation: Department of Physical Medicine and Rehabilitation, Johns Hopkins University, Baltimore, MD; Outcomes After Critical Illness and Surgery Research Group, Johns Hopkins University, Baltimore, MD.
authors.forename: Martin B
authors.initials: MB
authors.lastname: Brodsky
authors.affiliation: Outcomes After Critical Illness and Surgery Research Group, Johns Hopkins University, Baltimore, MD; Department of Biostatistics, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD.
authors.forename: Jonathan E
authors.initials: JE
authors.lastname: Gellar
authors.affiliation: Outcomes After Critical Illness and Surgery Research Group, Johns Hopkins University, Baltimore, MD; Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, MD.
authors.forename: Victor D
authors.initials: VD
authors.lastname: Dinglas
authors.affiliation: Outcomes After Critical Illness and Surgery Research Group, Johns Hopkins University, Baltimore, MD; Department of Biostatistics, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Colantuoni
authors.affiliation: Outcomes After Critical Illness and Surgery Research Group, Johns Hopkins University, Baltimore, MD; Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University, Baltimore, MD.
authors.forename: Pedro A
authors.initials: PA
authors.lastname: Mendez-Tellez
authors.affiliation: Division of Pulmonary and Critical Care Medicine, University of Maryland, Baltimore, MD.
authors.forename: Carl
authors.initials: C
authors.lastname: Shanholtz
authors.affiliation: Department of Physical Medicine and Rehabilitation, Johns Hopkins University, Baltimore, MD; Department of Otolaryngology-Head and Neck Surgery and Center for Functional Anatomy and Evolution, Johns Hopkins University, Baltimore, MD.
authors.forename: Jeffrey B
authors.initials: JB
authors.lastname: Palmer
authors.affiliation: Department of Physical Medicine and Rehabilitation, Johns Hopkins University, Baltimore, MD; Outcomes After Critical Illness and Surgery Research Group, Johns Hopkins University, Baltimore, MD; Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, MD. Electronic address: dale.needham@jhmi.edu.
authors.forename: Dale M
authors.initials: DM
authors.lastname: Needham
mesh_terms: D055371:Acute Lung Injury / Q000628:therapy*; D000368:Aged; D016001:Confidence Intervals; D003680:Deglutition Disorders / Q000175:diagnosis / Q000209:etiology*; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal / Q000009:adverse effects* / Q000706:statistics & numerical data; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011446:Prospective Studies; D012121:Respiration, Artificial / Q000706:statistics & numerical data; D057566:Self Report; D013997:Time Factors
keywords: Acute lung injury; Deglutition; Dysphagia; Intubation; Mechanical ventilation