title: Prevalence and management of oropharyngeal dysphagia in patients with severe anorexia nervosa: A large retrospective review.
abstract: OBJECTIVE
  Oropharyngeal dysphagia (OPD) refers to difficulty swallowing food or a liquid bolus from the oral and pharyngeal cavities into the esophagus and increases the risk of possibly life-threatening pneumonia. Little has been reported on OPD in adults with anorexia nervosa (AN). This study includes a description of OPD in severe AN and discusses potentially effective clinical management.
  
  
  METHODS
  Two hundred and six adults with severe AN, admitted over a five-year period to a national referral center specializing in the multidisciplinary medical stabilization of this population, were retrospectively evaluated by electronic database query and manual chart review. All patients whose initial medical assessment triggered a speech-language pathology (SLP) consultation, due to concerns for OPD, were reviewed in detail.
  
  
  RESULTS
  Of the 206 total patients, 42 presented with symptoms of OPD and received SLP consultation. In the OPD cohort, 37 (88%) were women, with median age 32 years old, and mean admission weights of 57% ideal body weight (IBW) and body mass index (BMI) of 12 kg/m(2). Compared with those who did not have OPD, OPD patients had significantly lower BMI on admission (12 kg/m(2) vs. 13.1 kg/m(2), p < 0.001), longer stay (21 days vs. 14 days, p < 0.001), and were more medically compromised, including a greater incidence of refeeding hypophosphatemia (60.9% vs. 29.7%, p < 0.004).
  
  
  CONCLUSIONS
  Clinical awareness of OPD may reduce the incidence of aspiration pneumonia and promote life-saving oral nutrition in patients with severe AN. Proper, timely evaluation and intervention may improve clinical outcomes.
authors: Department of Rehabilitation, Denver Health Medical Center, Denver, Colorado.
authors: Samantha R M
authors: SR
authors: Holmes
authors: Department of Patient Safety and Quality, Denver Health Medical Center, Denver, Colorado.|Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado Denver, Denver, Colorado.
authors: Allison L
authors: AL
authors: Sabel
authors: ACUTE Center for Eating Disorders at Denver Health Medical Center, Denver, Colorado.|Department of Medicine, University of Colorado Denver, Denver, Colorado.
authors: Jennifer L
authors: JL
authors: Gaudiani
authors: Department of Rehabilitation, Denver Health Medical Center, Denver, Colorado.
authors: Tricia
authors: T
authors: Gudridge
authors: ACUTE Center for Eating Disorders at Denver Health Medical Center, Denver, Colorado.|Department of Medicine, University of Colorado Denver, Denver, Colorado.
authors: John T
authors: JT
authors: Brinton
authors: ACUTE Center for Eating Disorders at Denver Health Medical Center, Denver, Colorado.|Department of Medicine, University of Colorado Denver, Denver, Colorado.|Eating Recovery Center, Denver, Colorado.
authors: Philip S
authors: PS
authors: Mehler
mesh_terms: D000328:Adult; D000856:Anorexia Nervosa / Q000150:complications* / Q000503:physiopathology; D015992:Body Mass Index; D001835:Body Weight; D003680:Deglutition Disorders / Q000150:complications / Q000453:epidemiology* / Q000523:psychology*; D005260:Female; D006760:Hospitalization; D006801:Humans; D017674:Hypophosphatemia / Q000209:etiology; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012017:Referral and Consultation; D012189:Retrospective Studies; D055815:Young Adult
keywords: anorexia nervosa; aspiration; deglutition disorder; oropharyngeal dysphagia