Abstract
Background: Dysphagia, (dysfunctional prehension, mastication,
or deglutition) describes a comorbidity of pathologies of the oral
cavity, pharynx, and esophagus that carries potentially serious health
consequences for horses. Given the diversity of differential diagnoses
that may result in dysphagia, an understanding of the prevalence of
dysphagia in hospitalized patients, the distribution of etiologies and
relative clinical outcomes could inform diagnosis, treatment, and
prognosis. Objectives: We hypothesize that clinical outcomes
would vary between dysphagia of different etiological origins, and that
neurogenic dysphagia would carry the lowest probability of recovery.
Study design: Retrospective cross-sectional study.
Methods: Referral hospital cases were screened and included in
the analysis for patients > 6 months of age with at least
one clinical sign of dysphagia and an etiological diagnosis for these
clinical signs. Cases were partitioned into one or more etiological
categories of dysphagia (oral, pharyngeal, esophageal, neurogenic) based
on recorded diagnosis. Associations between etiologies, predisposing
factors, treatments, and outcomes were evaluated by statistical
analysis. Results: Inclusion criteria was met for 182 cases.
Resolution of clinical signs for oral pharyngeal, and esophageal
etiologies of dysphagia was >80%, There were reduced odds of
recovery for dysphagia of neurogenic origin (OR 0.24, 95% CI 0.10-0.56,
p < 0.001). Patient age at presentation and use of antibiotic
and anti-inflammatory therapy was positively associated with patient
outcome across all dysphagia etiologies. Aspiration pneumonia was a
common sequela of dysphagia across all etiologies; but had no effect
dysphagia resolution. Main limitations: The retrospective
nature of the study was limited by the reliability and completeness of
the historical and clinical information. Observations in this study
population (referral hospital cases) may not be representative of all
dysphagia cases. Conclusions: Dysphagia is an uncommon
comorbidity in hospitalized patients. Prognosis is good for most
etiologies, but positive outcomes for dysphagia of neurogenic origin are
reduced.