Clinical Characteristics of Dysphagia in Adults: A Five-Year Retrospective Analysis at Hospital Pakar Universiti Sains Malaysia

Dyphagia in Adults
Vol. 20 No. 1 : 2025 (293-313)

Sarouji SH Sarouji SH
Mohd Azmarul A. Aziz Mohd Azmarul A. Aziz
Mohd Normani Zakaria Mohd Normani Zakaria
Hassan NFHN Hassan NFHN
Izzat Ismail Izzat Ismail

Abstract
Dysphagia, a swallowing disorder affecting oral, pharyngeal and oesophageal phases, requires effective treatment. The rising incidence of dysphagia each year highlights the need for more research in Malaysia. This study investigated its prevalence and characteristics among adult patients at the Speech Pathology Clinic, Hospital Pakar Universiti Sains Malaysia (HPUSM). Medical records of 125 patients aged >≥18, diagnosed with dysphagia between 2018 and 2023, were retrospectively analysed. Data on demographics, diagnosis methods, feeding types and dysphagia characteristics were collected. Logistic regression analyses determined associations between dysphagia types and socio-demographic factors. Dysphagia prevalence was 5.5%, predominantly affecting Malay patients aged ≥61, with a slight male predominance. Common medical histories included gastrointestinal diseases and was followed by stroke. The primary assessment method was fiberoptic endoscopic evaluation of swallowing (FEES) (61.6%). Oesophageal dysphagia was most prevalent (51%), followed by oropharyngeal dysphagia (28.8%). Issues included coughing while swallowing, weight loss, limited tongue mobility and aspiration. Oral feeding with diet modification and nasogastric tube feeding were common interventions. Age >≥61 years (OR = 6.016, 95% CI: 2.189, 16.531, p = 0.001) and referral sources (OR = 0.111, 95% CI: 0.029, 0.419, p = 0.001) significantly predicted dysphagia types. Dysphagia is a significant health issue among adults, particularly older individuals, necessitating focused management strategies and ongoing research in Malaysia.
Keywords : Adult patients; clinical characteristics; dysphagia; Malaysia; prevalence,
Abstrak
Disfagia, iaitu masalah penelanan pada fasa oral, faring dan esofagus memerlukan rawatan yang berkesan. Peningkatan insiden disfagia setiap tahun menunjukkan keperluan untuk lebih banyak kajian di Malaysia. Kajian ini bertujuan untuk menentukan prevalens dan ciri-ciri disfagia di kalangan pesakit dewasa di Klinik Patologi Pertuturan, Hospital Pakar Universiti Sains Malaysia (HPUSM). Rekod perubatan 125 pesakit berumur > 18 tahun, yang didiagnosis secara klinikal dengan disfagia antara 2018 dan 2023 telah dianalisis secara retrospektif. Data mengenai sosiodemografi, kaedah diagnosis, jenis pemakanan, dan ciri-ciri disfagia dikumpulkan. Analisis regresi logistik menentukan hubungan antara jenis disfagia dan ciri-ciri sosiodemografi. Prevalens disfagia di kalangan pesakit dewasa adalah 5.5%. Kebanyakan pesakit adalah Melayu, berumur ≥61 tahun, dengan lelaki lebih ramai berbanding wanita. Sejarah perubatan termasuk penyakit pencernaan dan gastrointestinal diikuti oleh strok. Kaedah penilaian 'fiberoptic endoscopic evaluation of swallowing' (FEES) adalah kaedah penilaian utama (61.6%). Disfagia esofagus adalah paling lazim berlaku (51%), diikuti oleh disfagia orofaring (28.8%). Masalah yang sering dihadapi termasuk batuk semasa menelan, penurunan berat badan, pergerakan lidah yang terhad dan aspirasi. Pemakanan oral dengan pengubahsuaian diet dan pemakanan tiub nasogastrik adalah intervensi yang biasa. Umur > 61 tahun (OR = 6.016, 95% CI: 2.189, 16.531, p = 0.001) dan sumber rujukan (OR = 0.111, 95% CI: 0.029, 0.419, p = 0.001) secara signifikan boleh meramalkan jenis disfagia. Kesimpulannya, disfagia adalah isu kesihatan yang signifikan di kalangan dewasa, terutamanya individu yang lebih tua dengan pelbagai jenis sejarah perubatan. Penekanan pada strategi pengurusan dan kajian berterusan di Malaysia adalah diperlukan.
Kata Kunci : Ciri-ciri klinikal; disfagia; Malaysia; pesakit dewasa; prevalens,

Correspondance Address
Mohd Azmarul A. Aziz. Speech Pathology Programme, School of Health Sciences, Universiti Sains Malaysia (Health Campus), 16150 Kubang Kerian, Kelantan, Malaysia. Tel: +609 7677662 Email: azmarul@usm.my