{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T21:06:12Z","timestamp":1792271172604,"version":"4.4.0"},"reference-count":42,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2025,6,16]],"date-time":"2025-06-16T00:00:00Z","timestamp":1750032000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Dysphagia is a serious complication following cardiac surgery, associated with increased morbidity, prolonged hospitalization, and higher healthcare costs. Variability in the incidence and risk factors highlights the need for consolidated evidence. This scoping review aimed to analyze the incidence of dysphagia after cardiac surgery and identify the associated risk factors. A search was conducted in the PubMed, Embase, Web of Sciences, and PEDro databases for observational studies reporting dysphagia incidence and risk factors in adult cardiac surgery patients. The Newcastle\u2013Ottawa Scale was used to assess the studies\u2019 quality and out of 2920 studies identified, 15 met the inclusion criteria for inclusion in this review. Dysphagia incidence ranged from 2.7% to 60%, with higher rates observed when objective assessments such as FEES or VFSS were employed. Key risk factors included advanced age, prolonged intubation, cerebrovascular events, and complex operative procedures. Post-operative dysphagia was linked to complications like aspiration pneumonia, prolonged ICU\/hospital stays, and increased healthcare costs. In conclusion, dysphagia is a significant but under-recognized complication of cardiac surgery. Advanced age, prolonged intubation, and surgical complexity are major risk factors. Standardized assessment protocols and early interventions are crucial to mitigating its impact and improving patient clinical outcomes.<\/jats:p>","DOI":"10.3390\/jcm14124279","type":"journal-article","created":{"date-parts":[[2025,6,16]],"date-time":"2025-06-16T09:51:22Z","timestamp":1750067482000},"page":"4279","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Incidence and Risk Factors of Dysphagia After Cardiac Surgery: A Scoping Review"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4348-2153","authenticated-orcid":false,"given":"Christos","family":"Kourek","sequence":"first","affiliation":[{"name":"Clinical Ergospirometry, Exercise & Rehabilitation Laboratory, 1st Critical Care Medicine Department, Evangelismos Hospital, National and Kapodistrian University of Athens, 10676 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vania","family":"Labropoulou","sequence":"additional","affiliation":[{"name":"Clinical Ergospirometry, Exercise & Rehabilitation Laboratory, 1st Critical Care Medicine Department, Evangelismos Hospital, National and Kapodistrian University of Athens, 10676 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7245-0882","authenticated-orcid":false,"given":"Emilia","family":"Michou","sequence":"additional","affiliation":[{"name":"Department of Speech Language Therapy, School of Health Rehabilitation Sciences, University of Patras, 26504 Patras, Greece"},{"name":"Centre for Gastrointestinal Sciences, Faculty of Biology, Medicine and Health, University of Manchester and the Manchester Academic Health Sciences Centre, Manchester M1 39PL, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2199-3788","authenticated-orcid":false,"given":"Stavros","family":"Dimopoulos","sequence":"additional","affiliation":[{"name":"Clinical Ergospirometry, Exercise & Rehabilitation Laboratory, 1st Critical Care Medicine Department, Evangelismos Hospital, National and Kapodistrian University of Athens, 10676 Athens, Greece"},{"name":"Cardiac Surgery ICU, Onassis Cardiac Surgery Center, 17674 Kallithea, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,6,16]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Karunaratne, T.B., Clav\u00e9, P., and Ortega, O. (2024). Complications of oropharyngeal dysphagia in older individuals and patients with neurological disorders: Insights from Matar\u00f3 hospital, Catalonia, Spain. Front. Neurol., 15.","DOI":"10.3389\/fneur.2024.1355199"},{"key":"ref_2","first-page":"664","article-title":"Quality of life in stroke patients with dysphagia: A systematic review","volume":"100","author":"Hassan","year":"2022","journal-title":"Tunis. Med."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"43","DOI":"10.15747\/ACNM.2024.16.2.43","article-title":"Dysphagia and quality of life: A narrative review","volume":"16","author":"Song","year":"2024","journal-title":"Ann. Clin. Nutr. Metab."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"890","DOI":"10.1177\/000313481608201006","article-title":"Dysphagia after cardiac operations is associated with increased length of stay and costs","volume":"82","author":"Nguyen","year":"2016","journal-title":"Am. Surg."},{"key":"ref_5","first-page":"119","article-title":"Incidence and impact of dysphagia in patients receiving prolonged endotracheal intubation after cardiac surgery","volume":"52","author":"Barker","year":"2009","journal-title":"Can. J. Surg."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"737","DOI":"10.1016\/j.jtcvs.2021.02.087","article-title":"Dysphagia after cardiac surgery: Prevalence, risk factors, and associated outcomes","volume":"165","author":"Plowman","year":"2023","journal-title":"J. Thorac. Cardiovasc. Surg."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1142","DOI":"10.1007\/s00455-021-10377-2","article-title":"Incidence and outcomes of laryngeal complications following adult cardiac surgery: A national analysis","volume":"37","author":"Verma","year":"2022","journal-title":"Dysphagia"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"490","DOI":"10.1016\/S1474-4422(14)70004-3","article-title":"Neurological complications of cardiac surgery","volume":"13","author":"McDonagh","year":"2014","journal-title":"Lancet Neurol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1545","DOI":"10.1177\/02676591221119312","article-title":"Neurologic complications after cardiopulmonary bypass\u2014A narrative review","volume":"38","author":"Gilbey","year":"2023","journal-title":"Perfusion"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"e24582","DOI":"10.1016\/j.heliyon.2024.e24582","article-title":"Risk factors for dysphagia in patients with acute and chronic ischemic stroke: A retrospective cohort study","volume":"10","author":"Mao","year":"2024","journal-title":"Heliyon"},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Yang, C., and Pan, Y. (2022). Risk factors of dysphagia in patients with ischemic stroke: A meta-analysis and systematic review. PLoS ONE, 17.","DOI":"10.1371\/journal.pone.0270096"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1895","DOI":"10.1111\/jgs.16039","article-title":"Association Between Postextubation Dysphagia and Long-Term Mortality Among Critically Ill Older Adults","volume":"67","author":"Regala","year":"2019","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"467","DOI":"10.7326\/M18-0850","article-title":"PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation","volume":"169","author":"Tricco","year":"2018","journal-title":"Ann. Intern. Med."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"517","DOI":"10.1016\/S0022-5223(95)70249-0","article-title":"Swallowing dysfunction after cardiac operations. Associated adverse outcomes and risk factors including intraoperative transesophageal echocardiography","volume":"110","author":"Hogue","year":"1995","journal-title":"J. Thorac. Cardiovasc. Surg."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"486","DOI":"10.1016\/S0003-4975(99)01086-3","article-title":"Risk of dysphagia after transesophageal echocardiography during cardiac operations","volume":"69","author":"Rousou","year":"2000","journal-title":"Ann. Thorac. Surg."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"568","DOI":"10.1016\/j.athoracsur.2015.03.077","article-title":"A novel risk score to predict dysphagia after cardiac surgery procedures","volume":"100","author":"Grimm","year":"2015","journal-title":"Ann. Thorac. Surg."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1016\/j.jcrc.2015.10.008","article-title":"Finding the red flags: Swallowing difficulties after cardiac surgery in patients with prolonged intubation","volume":"31","author":"Daly","year":"2016","journal-title":"J. Crit. Care"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1450","DOI":"10.1016\/j.athoracsur.2015.10.006","article-title":"Is dysphagia after cardiac operations a \u201cpreexisting condition\u201d?","volume":"101","author":"Bowles","year":"2016","journal-title":"Ann. Thorac. Surg."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1016\/j.jcrc.2018.01.027","article-title":"Dysphagia and laryngeal pathology in post-surgical cardiothoracic patients","volume":"45","author":"Miles","year":"2018","journal-title":"J. Crit. Care"},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Zhou, X.D., Dong, W.H., Zhao, C.H., Feng, X.F., Wen, W.W., Tu, W.Y., Cai, M.X., Xu, T.C., and Xie, Q.L. (2019). Risk scores for predicting dysphagia in critically ill patients after cardiac surgery. BMC Anesthesiol., 19.","DOI":"10.1186\/s12871-019-0680-3"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"894","DOI":"10.1111\/1460-6984.12492","article-title":"Clinical predictors for oropharyngeal dysphagia and laryngeal dysfunction after lung and heart transplantation","volume":"54","author":"Black","year":"2019","journal-title":"Int. J. Lang. Commun. Disord."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1016\/j.jacasi.2021.10.011","article-title":"Impact of frailty on postoperative dysphagia in patients undergoing elective cardiovascular surgery","volume":"2","author":"Ogawa","year":"2022","journal-title":"JACC Asia"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"602","DOI":"10.1093\/eurjcn\/zvac084","article-title":"Postoperative dysphagia as a predictor of functional decline and prognosis after undergoing cardiovascular surgery","volume":"22","author":"Ogawa","year":"2023","journal-title":"Eur. J. Cardiovasc. Nurs."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1016\/j.xjon.2024.02.002","article-title":"Impact of maximum phonation time on postoperative dysphagia and prognosis after cardiac surgery","volume":"18","author":"Ogawa","year":"2024","journal-title":"JTCVS Open"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"596","DOI":"10.1002\/lary.21403","article-title":"Laryngeal injury from prolonged intubation: A prospective analysis of contributing factors","volume":"121","author":"Noordzij","year":"2011","journal-title":"Laryngoscope"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1699","DOI":"10.1097\/CCM.0000000000004015","article-title":"Incidence and outcomes of acute laryngeal injury after prolonged mechanical ventilation","volume":"47","author":"Shinn","year":"2019","journal-title":"Crit. Care Med."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Zhang, L., Xie, Y., Ren, Z., and Xie, M. (2024). Transesophageal echocardiography related complications. Front. Cardiovasc. Med., 11.","DOI":"10.3389\/fcvm.2024.1410594"},{"key":"ref_28","first-page":"567","article-title":"Transoesophageal echocardiography related complications","volume":"53","author":"Mathur","year":"2009","journal-title":"Indian J. Anaesth."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1681","DOI":"10.1378\/chest.14-1133","article-title":"Swallowing dysfunction after critical illness","volume":"146","author":"Macht","year":"2014","journal-title":"Chest"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1080\/08998280.2015.11929174","article-title":"Postextubation dysphagia","volume":"28","author":"Rassameehiran","year":"2015","journal-title":"Bayl. Univ. Med. Cent. Proc."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"413","DOI":"10.1016\/j.rmed.2003.11.008","article-title":"Long-term mechanical ventilation and nutrition","volume":"98","author":"Ambrosino","year":"2004","journal-title":"Respir. Med."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"afac276","DOI":"10.1093\/ageing\/afac276","article-title":"New horizons in understanding oral health and swallowing function within the context of frailty","volume":"52","author":"Robison","year":"2023","journal-title":"Age Ageing"},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Yang, R.Y., Yang, A.Y., Chen, Y.C., Lee, S.D., Lee, S.H., and Chen, J.W. (2022). Association between dysphagia and frailty in older adults: A systematic review and meta-analysis. Nutrients, 14.","DOI":"10.3390\/nu14091812"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"563","DOI":"10.1378\/chest.105.2.563","article-title":"Pulmonary aspiration in mechanically ventilated patients with tracheostomies","volume":"105","author":"Elpern","year":"1994","journal-title":"Chest"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1097\/ALN.0b013e31829373fe","article-title":"Muscle weakness predicts pharyngeal dysfunction and symptomatic aspiration in long-term ventilated patients","volume":"119","author":"Mirzakhani","year":"2013","journal-title":"Anesthesiology"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.jsha.2015.05.002","article-title":"Outcomes of recurrent laryngeal nerve injury following congenital heart surgery: A contemporary experience","volume":"28","author":"Alfares","year":"2016","journal-title":"J. Saudi Heart Assoc."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"773","DOI":"10.1016\/j.ejcts.2004.06.003","article-title":"Vocal cord palsy as a complication of adult cardiac surgery: Surgical correlations and analysis","volume":"26","author":"Dimarakis","year":"2004","journal-title":"Eur. J. Cardiothorac. Surg."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"671","DOI":"10.1016\/S1010-7940(02)00019-2","article-title":"Vocal cord paralysis after open-heart surgery","volume":"21","author":"Hamdan","year":"2002","journal-title":"Eur. J. Cardiothorac. Surg."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"250","DOI":"10.1016\/j.bjae.2021.02.005","article-title":"Laryngeal complications after tracheal intubation and tracheostomy","volume":"21","author":"Wallace","year":"2021","journal-title":"BJA Educ."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1483","DOI":"10.1016\/j.healun.2021.08.006","article-title":"Swallowing and laryngeal complications in lung and heart transplantation: Etiologies and diagnosis","volume":"40","author":"Black","year":"2021","journal-title":"J. Heart Lung Transplant."},{"key":"ref_41","first-page":"295","article-title":"Implementation strategies to improve evidence-based practice for post-stroke dysphagia identification and management: A before-and-after study","volume":"9","author":"Zhang","year":"2022","journal-title":"Int. J. Nurs. Sci."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"587","DOI":"10.1093\/ageing\/afi187","article-title":"Improving care for patients with dysphagia","volume":"34","author":"Rosenvinge","year":"2005","journal-title":"Age Ageing"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/12\/4279\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T17:52:51Z","timestamp":1760032371000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/12\/4279"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,16]]},"references-count":42,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2025,6]]}},"alternative-id":["jcm14124279"],"URL":"https:\/\/doi.org\/10.3390\/jcm14124279","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6,16]]}}}