Table 3 Included studies reporting dysphagia attributable length of stay data

cohort

Altman, K. W., Yu, G. P., & Schaefer, S. D. (2010) USA [11]

Acute hospitalisations (conditions detailed in Table 4)

Admissions = 77,540,204 Dysphagia = 271,983

median 4.04 days (4.0–5.0; 95%CI)

median 2.4 days, (3.0–3.0; 95%CI) (data error?)

not reported

cohort

Arnold, M., Liesirova, K., Broeg-Morvay, A., Meisterernst, J., Schlager, M., Mono, M. L.,. Sarikaya, H. (2016) Switerland [27]

Ischaemic stroke

No dysphagia n = 452; mean age 64.9 years (SD = 14); Dysphagia n = 118 (20.7%); mean age 65.6 years (SD 14.5).

Total hospital LOS = 7.9 (SD = 4.8 days);

Stroke unit LOS = 4.4 (SD = 2.8)

Total hospital LOS 7.2 (SD = 4.4);

Stroke unit LOS 2.7 (SD = 2.4)

Total hospital LOS, p < 0.145;

Stroke unit LOS p < 0.001

cohort

Bradley, J. F., 3rd, Jones, M. A., Farmer, E. A., Fann, S. A., & Bynoe, R. (2011) USA [28]

Cervical spine injury (blunt trauma)

No dysphagia n = 19, mean age 36.9y; Dysphagia n = 37, mean age 42.2y

Total LOS = 10.162 days (SD = 7.13);

ICU LOS = 5.486 days (SD = 6.06).

Total LOS 6 days (SD 4.28);

ICU LOS 4 days (SD 8.1)

Total LOS p = 0.083;

ICU LOS p = 0.019

cohort

Chaw, E., Shem, K., Castillo, K., Wong, S. L., & Chang, J. (2012) USA [35]

Tetraplegia

Admissions n = 63; mean age 43 years (SD = 17.2); Dysphagia n = 21 (30.9%); mean age 48.6y (SD = 18.4)

47.9 (+/−20.8) days

38.7 (+/−17.0) days

p = 0.87

cohort

Falsetti, P., Acciai, C., Palilla, R., Bosi, M., Carpinteri, F., Zingarelli, A.,. .Lenzi, L. (2009) Italy [37]

neurorehab (non acute) ischaemic or haemorrhagic stroke

No dysphagia n = 89 (58.9%); mean age 78.6y (SD = 6.6); Dysphagia n = 62 (41%); mean age 80.7y (SD = 5.4)

35 days (range = 13–93, SD = 16.7)

26.6 days (range = 6–60, SD = 12.3)

p = 0.0012

cohort

Ferraris, V. A., Ferraris, S. P., Moritz, D. M., & Welch, S. (2001) USA [38]

post cardiac surgery

No dysphagia n = 1011 (97%), mean age = 62.8 (SD = 11.8); Dysphagia n = 31 (3%), mean age 71.9y (SD = 8.3)

16.1 days (SD = 11.7)

5.7 days (SD = 3.1)

p < 0.0001

cohort

Genther, D. J., & Gourin, C. G. (2015) USA [16]

Head and neck cancer patients who underwent ablative surgery.

61,740 patients, median age 73y (range 66–104); Dysphagia n = 4461 (7.2%)

10 days. Intercept + 0.2242 (0.1419–0.3065 95%CI)

8 days, intercept 0.8448 (0.7211–0.9684 95%CI)

p < 0.001

cohort

Guyomard, V., Fulcher, R. A., Redmayne, O., Metcalf, A. K., Potter, J. F., & Myint, P. K. (2009) UK [39]

Stroke (ischaemic or haemorrhagic)

No dysphagia n = 1477, mean age 75y (SD = 12.1); Dysphagia n = 1506, Mean age 79y (SD = 9.7).

16.0 days (SD = 9.9)

10.5 days (SD = 6.3)

< 0.001

cohort

Hogue, C. W., Jr., Lappas, G. D., Creswell, L. L., Ferguson, T. B., Jr., Sample, M., Pugh, D., Lappas, D. G. (1995) USA [29]

acute hospitalisation with cardiopulomoary bypass

No dysphagia n = 835, mean age 63 y (+/−  0.4), Dysphagia n = 34, 71y (+/−2)

ICU = 15.1 days (+/−  3.1),

Post operative LOS = 33.4 days (+/−  4.4)

ICU = 4.4 days (+/−  0.2);

Post operative LOS = 12.3 days (+/−  0.4)

p = 0.0001

cohort

Holmes, S. R. M., Sabel, A. L., Gaudiani, J. L., Gudridge, T., Brinton, J. T., & Mehler, P. S. (2016) USA [32]

Anorexia nervosa

No dysphagia n = 164, 27 y (22–35); Dysphagia n = 42, 32 years (23–47)

median = 21 days (IQR = 14–27)

Median = 14 days (IQR = 9–20)

p < 0.001

cohort

Nilsson, H., Ekberg, O., Olsson, R., & Hindfelt, B. (1998). Sweden [31]

Stroke

No Dysphagia n = 58; Dysphagia n = 14.

median = 14 days (IQR = 8–47)

median = 10 days (IQR = 6–22)

Not significant

cohort

Odderson, I. R., Keaton, J. C., & McKenna, B. S. (1995) USA [42]

Acute non-haemorrhagic stroke

No-Dysphagia n = 76, age = 75.3y (+/− 1.4); Dysphagia n = 48; age = 75.2y (+/− 1.5)

8.4 days (+/−  0.9)

6.4 days (+/−  0.6)

p = 0.05

cohort

Rao, N., Brady, S., Chaudhuri, G., Ruroede, K., & Caldwell, R. 2005 [26]

Stroke

No dysphagia n = 380 (42%); Dysphagia n = 527 (58%)

22.08 days

16.18 days

p < 0.001

cohort

Smithard, D. G., O’Neill, P. A., Parks, C., & Morris, J. 1996, UK [12]

Stroke

No dysphagia n = 61; Dysphagia n = 60 patients

44.8 days (32–62; 95%CI)

24.5 days (18–33; CI = 95%)

p < 0.001

cohort

Teasell, R., Foley, N., Fisher, J., & Finestone, H, 2002 Canada [43]

Medullary stroke

No Dysphagia n = 9, mean age = 55y (+/−  16); Dysphagia n = 11 (mean; age: 57 +/− 16)

Total hospital: 66 days (+/− 17);

Rehabilitation: 48 days (+/− 14)

Total hospital: 44 days (+/− 22).

Rehabilitation: 24 days (+/− 17)

Total hospital p = 0.023,

Rehabilitation p = 0.002

cohort

Westergren, A., Hallberg, I. R., & Ohlsson, O. (1999). Sweden [33]

Stroke

Total n = 96, mean age 74.3y (SD = 9.6), Dysphagia n = 35, mean age 74.6y (SD = 7.6)

53.9 days (+/− 35.9)

25.2 days (+/− 24.6)

p < 0.001

cohort

Young, E. C., & Durant-Jones, L. (1990). USA [30]

Stroke

No Dysphagia n = 35, mean age 61 yrs.; Dysphagia n = 65, mean age 75 yrs

mean LOS = 53.06; median LOS = 32

mean LOS = 22.10 days; median LOS = 15 days

p < 0.0002 (calculated from median)

cross section

Chan, J. Y., Li, R. J., & Gourin, C. G. (2013) USA [45]

Head and neck cancer patients who underwent ablative surgery.

Total n = 7791, mean age 53.4 years (range 18–89); Dysphagia = 6.6% of total

Add 2.5 days compared with whole sample (95% CI .5307–.8021, estimate .6664, p < 0.001).

Whole sample = 3.7 days (95% CI 0.0205–0.9909)

p < 0.001

cross section

Semenov, Y. R., Starmer, H. M., & Gourin, C. G. (2012). USA [46]

Head and neck cancer patients who underwent ablative surgery.

Total n = 93,636, Dysphagia = 5.6% of total

Add 2.8 days to total sample

7.3 days (estimate: 0.1998, 95%CI 0.1364–0.2632)

p < 0.001

cross section

Starmer, H. M., Riley, L. H., 3rd, Hillel, A. T., Akst, L. M., Best, S. R., & Gourin, C. G. 2004, USA [47]

Anterior Cervical Disc surgery

Total n = 1,659,871; Dysphagia n = 32,922 (2%).

Add 1.2 days to total sample, estimate: 0.558 (0.05173–0.7908)

2.2 days (estimate 0.4742 (0.4523–0.4961)

p < 0.001

cross section

Ward, B. K., Francis, H. W., Best, S. R., Starmer, H. M., Akst, L. M., & Gourin, C. G. (2012) USA [48]

Vagus nerve injury due to vestibular schwannoma.

Total n = 17,281, mean age 50.4 yrs. (range 18–97); Dysphagia n = 443

Add 1.72 days to total sample (0.23–0.49, 95%CI)

intercept 4.73 days

p = 0.001

case series

Chen, C. J., Saulle, D., Fu, K. M., Smith, J. S., & Shaffrey, C. I. (2013) USA [49]

Combined anterior-posterior cervical spine surgery

Total n = 30, mean age = 59.1 y (range 36–80); Dysphagia n = 13 (43.3%), mean age 60.7 years (SD = 7.2).

10.8 days (SD 4.9)

5.9 days (SD 2.6)

p = 0.004;

After adjustment for age, LOS remained significantly p = 0.021

case series

Field, L. H., & Weiss, C. J. (1989) USA [50]

Traumatic Brain Injury

Total n = 30, Dysphagia n = 9 (30%)

126.7 days

52.3 days

None; descriptive only. No indication of variance or CIs