Transitioning to oral feeding from other routes in the palliative care unit

Aims: The evaluation of swallowing in the palliative care (PC) unit (PCU) is an important indicator of care. In this study, we investigated how an on-admission swallowing test in the PCU guides the course of the feeding route. Methods: This single-center, retrospective study included PC patients who...

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Bibliographic Details
Published in:Gulhane Medical Journal 2023-12, Vol.65 (4), p.152-159
Main Authors: Zengin, Hilal, Evin, Nimet, Unlu, Ceren Ersoz, Arici, Sena, Yildirim, Vedat, Tasci, Ilker
Format: Article
Language:English
Subjects:
Deglutition disorders
dysphagia
enteral feeding
Medical research
Medicine, Experimental
Methylene blue
oral feeding
palliative care unit
Palliative treatment
swallowing test
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Summary:Aims: The evaluation of swallowing in the palliative care (PC) unit (PCU) is an important indicator of care. In this study, we investigated how an on-admission swallowing test in the PCU guides the course of the feeding route. Methods: This single-center, retrospective study included PC patients who underwent bedside swallowing evaluation. The main exclusion criteria were gastrointestinal failure requiring permanent parenteral nutrition, no swallowing test upon admission, and a length of stay shorter than four days. The primary endpoint was the proportion of patients with dysphagia who transitioned to oral feeding. Results: The study included 63 patients [age, median interquartile range: 80.0 (14) years (37 to 94 years); males: 54.0%]. Thirty-six (57.1%) of 63 admissions had dysphagia, whereas 27 (42.9%) patients had no dysphagia. The route of feeding was modified in 50.8% of the samples during their PCU stay. The proportion of patients who returned to oral feeding was 30.2% (n=19), whereas 6.3% (n=4) and 12.7% (n=8) of the sample underwent nasoenteral tube and percutaneous endoscopic gastrostomy (PEG) placement, respectively. Among the 32 patients who were on tube feeding on admission, 12 (37.5%) returned to oral feeding during their PCU stay. Seven (58.4%) of these subjects who regained oral feeding were on nasoenteral tube feeding and 5 (41.6%) were on PEG feeding on admission. Conclusions: This study showed a high rate of dysphagia on admission to the PCU. On the other hand, safe and adequate oral feeding could be re-initiated in almost one-third of patients with dysphagia on admission. Keywords: Palliative care unit, dysphagia, swallowing test, oral feeding, enteral feeding
ISSN:1302-0471
2146-8052
DOI:10.4274/gulhane.galenos.2023.50023