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Early Speech-Language Pathology Consultation and Pneumonia After Cardiac Surgery




Cardiac surgery patients are at high risk for oropharyngeal dysphagia and aspiration, which may predispose them to respiratory complications like pneumonia. Speech-language pathology consultation facilitates early identification of swallowing difficulties and prompt intervention. A recent study at Johns Hopkins University (Kumble S, et al., Am J Speech Lang Pathol. 2022 Sep 7;31(5):2123-2131. doi: 10.1044/2022_AJSLP-21-00310) has explored the association between pneumonia and the timing of speech-language pathology after cardiac surgery.

This was performed retrospectively on adults in a tertiary care center, from July 2016 through December 2019. Patients with preexisting tracheostomy on admission were excluded. 2,864 patients met the inclusion criteria. Speech-language pathology was ordered for 473 cases (16.5%), and clinical swallow evaluation (CSE) was completed by speech-language pathology in 419 patients (88.6%), of whom 309 were suspected to have dysphagia (73.7%). Among the 2,391 patients without speech-language pathology consultation, pneumonia was reported in 34 patients (1.42%). Pneumonia was reported in 53 patients in the speech-language pathology cohort, of which 43 patients (13.9%) were suspected to have dysphagia. Patients with pneumonia had significantly longer median time (20.0 hr, range: 4.9-26.7) from speech-language pathology orders to completion of CSE, compared to those without pneumonia (13.2 hr, range: 3.2-22.4, p = .025). There was no significant difference in the median time from extubation to speech-language pathology consultation order time in patients with pneumonia versus those without pneumonia. Patients with pneumonia were observed to have prolonged, although not statistically significant, median time from extubation to CSE (70.4 hr, range: 21.2-215) compared to those without pneumonia (42.2 hr, range: 19.5-105.8, p = .066).

Patients without pneumonia in the postoperative period were observed to have shorter median time from extubation to speech-language pathology evaluation. Future studies are needed to further understand any causative impact of early speech-language pathology consultation and incidence of pneumonia in this population.

MyoNews from BreatheWorksTM is a report on trends and developments in oromyofunctional disorder and therapy. These updates are not intended as diagnosis, treatment, cure or prevention of any disease or syndrome.

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