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RESUMEN Introducción: La disfagia tiene una morbimortalidad importante en pacientes hospitalizados. Objetivos: principal; describir las características de los pacientes con disfagia hospitalizados y, secundarios; cuantificar y analizar la prevalencia de mortalidad y de reingresos. Metodología: Estudio transversal descriptivo de las hospitalizaciones por disfagia durante el año 2015 en un Hospital General Universitario. Resultados: Se evaluaron 431 historias clínicas. La edad de los pacientes fue de 83,21 (DE 11,4) años, el 52,5% fueron mujeres y el 47,2% varones; la estancia media fue de 11,1 (DE 7,99) días. En el 71,2 % de los casos la disfagia fue por afectación de la fase orofaríngea. En el 80,51% de los casos se diagnosticaron complicaciones respiratorias: 48,12% neumonía aspirativa por líquidos, 40,05 % neumonitis química por aspiración y 11,81% neumonía aspirativa por sólidos. La mortalidad general asociada a las complicaciones respiratorias respecto del total de los casos de disfagia fue del 24,49%. El 50,48% de los pacientes con neumonía aspirativa fallecieron. La principal causa de la disfagia fue las enfermedades neurológicas (un 77,25%). La mortalidad fue significativamente mayor en las mujeres - 42,3% frente al 7,8% - (p < 0,01) y esta diferencia se mantuvo tras ajustar el resultado por edad: OR 9,937, IC95%: 5,446; 18,131. El 13,10% de los pacientes reingresaron al menos en una ocasión. Los pacientes de geriatría presentaron un mayor número de reingresos por número de ingresos. Discusión: las enfermedades neurológicas fueron la principal causa de disfagia. La mortalidad fue significativamente mayor en las mujeres. ABSTRACT Introduction: Dysphagia is an important associated morbidity and mortality in hospitalized patient. Objectives: Main; to describe the characteristics of patients admitted for dysphagia and secondary; quantify and analyze the prevalence of mortality and readmissions. Methodology: Cross-sectional study descriptive revenues by dysphagia during the year 2015 in a University General Hospital. Results: 431 records were evaluated. The age of the patients was 83,21 (11.4), 52.5% women and 47.2% male; the average stay was 11.1 (7.99) days. In 71,2% of cases the dysphagia was involvement of the oropharyngeal phase. 80.51% of cases were diagnosed respiratory complications. The percentage distribution of these complications were: in 48.12% aspiration pneumonia due to fluids, in 40.05% chemical aspiration pneumonitis and in 11.81% aspiration pneumonia due to solids. The overall mortality associated with respiratory complications compared to the total of cases of dysphagia was 24.49%. 50.48% of patients diagnosed with aspiration pneumonia died. The main cause of dysphagia was neurological diseases (77.25%). Mortality was significantly higher in women - 42.3% of women compared with 7.8% of males - (p < 0.01) and this difference remained after adjusting the result by age: OR 9,937, 95% CI: 5,446; 18,131. 13.10% of patients re-entered at least on one occasion. Patients of geriatric unit that presented in greater number of readmissions by admissions. Discussion: neurological diseases were the main cause of dysphagia. Mortality was significantly higher in women

Background/objectives To elicit and compare preferences in terms of the attributes of home enteral nutrition (HEN) among patients and physicians, using a discrete choice experiment (DCE). Subjects/methods A DCE comprising eight choice scenarios, with six HEN attributes (tolerability, adaptation to comorbidities, nutrition and calories, handling, connections and information; two levels each) was designed. The Relative Importance (RI) for patients and physicians of each attribute was estimated. Sociodemographic and clinical variables, as well as additional questions (n = 8) were compiled to analyze possible explanatory variables and other preferences. Results A total of 148 HEN patients (71 needing caregivers to answer on their behalf) and 114 physicians completed the DCE. The most important attributes for patients were adaptation to comorbidities (33% RI), tolerability (33% RI), and nutrition and calories (26% RI). Significantly, younger patients had stronger preferences for tolerability whereas elderly ones (≥75 years) were more concerned about handling. In comparison, physicians gave a higher RI to tolerability, and nutrition and calories compared to patients (p = 0.002). Overall, a higher percentage of physicians answered that HEN characteristics such as easy-handling bags (85.1 vs. 64.9%; p = 0.001), container material (69.3 vs. 57.1%; p = 0.003) or reusable containers (79.8 vs. 70.3%; p = 0.01) were “important” or “very important” compared to patients. Conclusions Our findings showed that although patients and physicians have a similar perception about the relevance of different HEN attributes, the relative weight given to each one varies between them. Therefore, both points of view should be considered when choosing a HEN product in order to improve patients’ satisfaction and clinical outcomes.

Establishing a home enteral nutrition (HEN) that is adapted to the patient's needs and preferences can improve their quality of life and adherence, contributing to a higher treatment efficiency, better prognosis and cost reduction. As in most cases, patients need total or partial help from their caregivers, and there is a need for evaluating how well do caregivers know their patients' priorities.Exploring patients' preferences for HEN characteristics in Spain, and the concordance between patients and caregivers.A cross-sectional observational study based on the discrete choice experiment methodology. A set of eight choice scenarios generated from six attributes with two levels each was presented along with an ad hoc questionnaire on the importance and satisfaction with HEN. The relative importance (RI) of each attribute and the patient-caregiver concordance was estimated in every question.One hundred and forty-eight patients participated, and in 77 cases both the patient and the caregiver took the survey. The most important attributes (RI) for HEN were adaptation to comorbidities (33%), tolerability (33%), nutrients and calories (26%) and package characteristics (8%). Patients showed a high degree of satisfaction with the assistance received. Concordance between patient and caregiver was found in every question, being it moderate to good.According to patients, an ideal HEN product would be adaptable to comorbidities, easy to tolerate, providing the necessary nutrients and calories, with an easy to handle package. Caregivers know well their patients' preferences.

Introduccion: establecer una nutricion enteral domiciliaria (NED) adaptada a las necesidades y preferencias del paciente puede mejorar la calidad de vida y la adherencia, contribuyendo a una mayor eficiencia del tratamiento, mejor pronostico y reduccion de costes. En muchos casos los pacientes requieren ayuda total o parcial de cuidadores, por lo que es importante evaluar hasta que punto estos conocen sus preferencias. Objetivos: explorar las preferencias de los pacientes por las caracteristicas de la NED en Espana, y la concordancia entre paciente y cuidador. Metodos: estudio observacional, transversal, basado en la metodologia del experimento de eleccion discreta. Se presentaron ocho escenarios de eleccion generados a partir de seis atributos con dos niveles, y un cuestionario ad hocde importancia y satisfaccion con la NED. Se estimo la importancia relativa (IR) de cada atributo y la concordancia paciente-cuidador en todas las cuestiones. Resultados: participaron 148 pacientes; en 77 casos cumplimentaron las cuestiones los pacientes y sus cuidadores. Los atributos mas importantes (IR) en la NED fueron adaptabilidad a comorbilidades (33%), tolerabilidad (33%), aporte de nutrientes y calorias (26%) y caracteristicas del envase (8%). Los pacientes mostraron un elevado grado de satisfaccion con la asistencia recibida. Se encontro concordancia paciente-cuidador en todas las cuestiones, siendo esta de moderada a buena. Conclusiones: segun los pacientes, el producto para NED ideal se adapta a las comorbilidades, es facilmente tolerable, y aporta los nutrientes y calorias necesarios, con un envase de facil manejo. Los cuidadores conocen bien las preferencias del paciente.