title: [Factors associated with mortality in patients with dysphagia help in making dietary and nutritional choices].
abstract: OBJECTIVE
  To know what factors evaluated at the moment of admission are related with mortality among in-patients with dysphagia, during their stay in a longterm care hospital and may guide the dietary and nutritional intervention.
  
  
  METHODS
  Retrospective, observational and descriptive cohort study over patients with dysphagia diagnosed by Volumen-Viscosity Clinical Exploration Method (VVCEM). Demographic and clinical variables were gathered, stay, mortality, when their dysphagia was re-evaluated and treatments.
  
  
  RESULTS
  182 patients were included, medium age of 78 years old, 50% of them died. Following factors were significantly associate with death by univariant analysis: aged 85 or older, previous diagnosis of dysphagia, oncological disease, high co-morbidity (Charlson between 2-5 and > 5 points), low functionality before hospitalization (Barthel Index < 40), MNA < 17 points, albumen < 3 g/ dl, high score in CONUT (5-12 points), to be on opioids, neuroleptics, antidepressants while performing VVCEM, and the assistance aim when admission. Following factors had signification for risk to die by multi-variant analysis: age, oncological disease, co-morbidity and albumen, but taking antidepressants turned out to be a protective factor. Analysis of contrast was applied by curve ROC. The area under the curve was 0.740 and the confidence interval (CI) 0.668-0.811.
  
  
  CONCLUSIONS
  The above-mentioned information that may be evaluated in patients with dysphagia when admission, may help to define of more suitable and precocious form our welfare aims. In those cases with major risk of dying, it should prioritize comfort and safe swallowing. In those cases with low risk, in addition, should be effective improve to the maximum their nutritional condition.
authors.affiliation: Graduada en Enfermería. Unidad de Dietética y Nutrición. Hospital Pare Jofré. Agencia Valenciana de Salut. Conselleria de Sanitat. Valencia. España.. ferrero_isa@gva.es.
authors.forename: María Isabel
authors.initials: MI
authors.lastname: Ferrero López
authors.affiliation: Doctor en Farmacia. Universidad Católica de Valencia..
authors.forename: José Enrique
authors.initials: JE
authors.lastname: De la Rubia Ortí
authors.affiliation: Médico Internista. Área Médica Integral. Hospital Pare Jofré. Agencia Valenciana de Salut. Conselleria de Sanitat. Valencia. España..
authors.forename: Enrique
authors.initials: E
authors.lastname: Castellano Vela
authors.affiliation: Doctor en Medicina. Área Médica Integral. Hospital Pare Jofré. Agencia Valenciana de Salut. Conselleria de Sanitat. Valencia. España..
authors.forename: Carmen
authors.initials: C
authors.lastname: González Monte
authors.affiliation: Médico Internista. Área Médica Integral. Hospital Pare Jofré. Agencia Valenciana de Salut. Conselleria de Sanitat. Valencia. España..
authors.forename: Vicente
authors.initials: V
authors.lastname: Sanchis-Bayarri Bernal
authors.affiliation: Doctor en Medicina. Área Médica Integral. Hospital Pare Jofré. Agencia Valenciana de Salut. Conselleria de Sanitat. Valencia. España..
authors.forename: Ramón
authors.initials: R
authors.lastname: Navarro Sanz
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003680:Deglutition Disorders / Q000178:diet therapy* / Q000401:mortality*; D004032:Diet; D005260:Female; D006801:Humans; D008297:Male; D009752:Nutritional Status; D012189:Retrospective Studies; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology