{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T06:54:04Z","timestamp":1791269644086,"version":"4.1.0"},"reference-count":33,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2016,11,9]],"date-time":"2016-11-09T00:00:00Z","timestamp":1478649600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Am J Alzheimers Dis Other Demen"],"published-print":{"date-parts":[[2017,2]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>To assess the impact of dysphagia on clinical and operational outcomes in hospitalized patients with dementia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>Retrospective cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting:<\/jats:title>\n                    <jats:p>2012 Nationwide Inpatient Sample.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants:<\/jats:title>\n                    <jats:p>All patients discharged with a diagnosis of dementia (N = 234,006) from US hospitals in 2012.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements:<\/jats:title>\n                    <jats:p>Univariate and multivariate regression models, adjusting for stroke and patient characteristics, to assess the impact of dysphagia on the prevalence of comorbidities, including pneumonia, sepsis, and malnutrition; complications, including mechanical ventilation and death; and operational outcomes, including length of stay (LOS) and total charges for patients with dementia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Patients having dementia with dysphagia (DWD) had significantly higher odds of having percutaneous endoscopic gastrostomy placement during the admission (odds ratio [OR]: 13.68, 95% confidence interval [CI]: 12.53-14.95, P &lt; .001), aspiration pneumonia (OR: 6.27, 95% CI: 5.87-6.72, P &lt; .001), pneumonia (OR: 2.84, 95% CI: 2.67-3.02, P &lt; .001), malnutrition (OR: 2.5, 95% CI: 2.27-2.75, P &lt; .001), mechanical ventilation (OR: 1.69, 95% CI: 1.51-1.9, P &lt; .001), sepsis (OR: 1.52, 95% CI: 1.39-1.67, P &lt; .001), and anorexia (OR: 1.29, 95% CI: 1.01-1.65, P = .04). Mean LOS was 2.16 days longer (95% CI: 1.98-2.35, P &lt; .001), mean charge per case was US$10,703 higher (95% CI: US$9396-US$12,010, P &lt; .001), and the odds of being discharged to a skilled nursing, rehabilitation, or long-term facility was 1.59 times higher (95% CI: 1.49-1.69, P &lt; .001) in the DWD cohort compared to patients having dementia without dysphagia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Dysphagia is a significant predictor of worse clinical and operational outcomes including a 38% longer LOS and a 30% increase in charge per case among hospitalized patients with dementia. Although these findings may not be surprising, this new evidence might bring heightened awareness for the need to more thoughtfully support patients with dementia and dysphagia who are hospitalized.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1533317516673464","type":"journal-article","created":{"date-parts":[[2016,11,7]],"date-time":"2016-11-07T20:45:14Z","timestamp":1478551514000},"page":"5-11","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":50,"title":["A Nationwide Study of the Impact of Dysphagia on Hospital Outcomes Among Patients With Dementia"],"prefix":"10.1177","volume":"32","author":[{"given":"Suchitra","family":"Paranji","sequence":"first","affiliation":[{"name":"Divisions of Hospital Medicine, Johns Hopkins Bayview Medical Center, Johns Hopkins University, Baltimore, MD, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neethi","family":"Paranji","sequence":"additional","affiliation":[{"name":"Divisions of Hospital Medicine, Johns Hopkins Bayview Medical Center, Johns Hopkins University, Baltimore, MD, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott","family":"Wright","sequence":"additional","affiliation":[{"name":"General Internal Medicine, Johns Hopkins Bayview Medical Center, Johns Hopkins University, Baltimore, MD, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shalini","family":"Chandra","sequence":"additional","affiliation":[{"name":"Divisions of Hospital Medicine, Johns Hopkins Bayview Medical Center, Johns Hopkins University, Baltimore, MD, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2016,11,9]]},"reference":[{"key":"bibr1-1533317516673464","unstructured":"US Census Bureau. International programs\u2014world population by age and sex. Web site. https:\/\/www.census.gov\/population\/international\/data\/worldpop\/tool_population.php. Accessed January 27, 2016."},{"key":"bibr2-1533317516673464","unstructured":"Millennials outnumber baby boomers and are far more diverse. Web site: http:\/\/www.census.gov\/newsroom\/press-releases\/2015\/cb15-113.html. Accessed January 16, 2016."},{"key":"bibr3-1533317516673464","unstructured":"WHO. 10 facts on dementia. Web site. http:\/\/www.who.int\/features\/factfiles\/dementia\/en\/. Accessed January 16, 2016."},{"key":"bibr4-1533317516673464","doi-asserted-by":"publisher","DOI":"10.1016\/j.jalz.2015.02.003"},{"key":"bibr5-1533317516673464","doi-asserted-by":"publisher","DOI":"10.1016\/j.gerinurse.2007.10.015"},{"key":"bibr6-1533317516673464","doi-asserted-by":"publisher","DOI":"10.1097\/WAD.0b013e318192a539"},{"key":"bibr7-1533317516673464","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.73.4.371"},{"key":"bibr8-1533317516673464","doi-asserted-by":"publisher","DOI":"10.1016\/j.archger.2012.04.011"},{"key":"bibr9-1533317516673464","doi-asserted-by":"publisher","DOI":"10.3233\/JAD-2010-1316"},{"key":"bibr10-1533317516673464","doi-asserted-by":"publisher","DOI":"10.1001\/archoto.2010.129"},{"key":"bibr11-1533317516673464","doi-asserted-by":"publisher","DOI":"10.1016\/j.otc.2013.08.008"},{"key":"bibr12-1533317516673464","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.0000190056.76543.eb"},{"key":"bibr13-1533317516673464","doi-asserted-by":"publisher","DOI":"10.1016\/j.eurger.2011.08.007"},{"key":"bibr14-1533317516673464","doi-asserted-by":"publisher","DOI":"10.1016\/j.nurpra.2009.11.010"},{"key":"bibr15-1533317516673464","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.295.6595.411"},{"key":"bibr16-1533317516673464","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2009.02526.x"},{"key":"bibr17-1533317516673464","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2007.02.032"},{"key":"bibr18-1533317516673464","volume-title":"Nationwide Inpatient Sample Redesign Final Report","author":"Houchens RL","year":"2014"},{"issue":"3","key":"bibr19-1533317516673464","first-page":"63","volume":"27","author":"Hughes JS","year":"2006","journal-title":"Health Care Financ Rev"},{"key":"bibr20-1533317516673464","unstructured":"State Alzheimer\u2019s Disease Plan Resource Center. The National Alzheimer\u2019s Project Act (NAPA). Web site. http:\/\/napa.alz.org\/national-alzheimers-project-act-backgroun. Accessed February 5, 2016."},{"key":"bibr21-1533317516673464","doi-asserted-by":"publisher","DOI":"10.1016\/j.jalz.2014.02.001"},{"issue":"6","key":"bibr22-1533317516673464","first-page":"12","volume":"61","author":"Galicia-Castillo M","year":"2006","journal-title":"Geriatrics"},{"key":"bibr23-1533317516673464","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.1997.00440240091014"},{"key":"bibr24-1533317516673464","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2000.02079.x"},{"key":"bibr25-1533317516673464","doi-asserted-by":"publisher","DOI":"10.1001\/jama.282.14.1365"},{"issue":"24","key":"bibr26-1533317516673464","first-page":"1869","volume":"344","author":"Finucane TE","year":"2001","journal-title":"N Engl J Med"},{"issue":"4","key":"bibr27-1533317516673464","first-page":"17","volume":"30","author":"Fuller RL","year":"2008","journal-title":"Health Care Finance Rev"},{"key":"bibr28-1533317516673464","doi-asserted-by":"publisher","DOI":"10.1097\/01.CCM.0000164543.14619.00"},{"key":"bibr29-1533317516673464","unstructured":"CDC. The Cost of Sepsis\u2014Safe Healthcare Blogs. Web site. http:\/\/blogs.cdc.gov\/safehealthcare\/2015\/09\/08\/the-cost-of-sepsis\/. Accessed February 6, 2016."},{"key":"bibr30-1533317516673464","doi-asserted-by":"publisher","DOI":"10.1177\/014556130108000818"},{"key":"bibr31-1533317516673464","unstructured":"How much does video fluoroscopic Swallowing Study Cost? What is a video fluoroscopic swallowing study? Web site. https:\/\/www.mdsave.com\/procedures\/videofluoroscopic-swallowing-study\/d785fdcc. Accessed February 6, 2016."},{"key":"bibr32-1533317516673464","unstructured":"The Henry J. Kaiser Family Foundation. Hospital Adjusted Expenses per Inpatient Day. Web site. http:\/\/kff.org\/other\/state-indicator\/expenses-per-inpatient-day\/. Accessed February 6, 2016."},{"key":"bibr33-1533317516673464","unstructured":"Frequently asked questions: swallowing and feeding (dysphagia). Web site. http:\/\/www.asha.org\/slp\/clinical\/dysphagia\/dysphagia_faqs\/. Accessed February 4, 2016."}],"container-title":["American Journal of Alzheimer's Disease &amp; Other Dementias\u00ae"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1533317516673464","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/1533317516673464","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1533317516673464","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T09:20:21Z","timestamp":1777368021000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/1533317516673464"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,11,9]]},"references-count":33,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2017,2]]}},"alternative-id":["10.1177\/1533317516673464"],"URL":"https:\/\/doi.org\/10.1177\/1533317516673464","relation":{},"ISSN":["1533-3175","1938-2731"],"issn-type":[{"value":"1533-3175","type":"print"},{"value":"1938-2731","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,11,9]]}}}