Demographics
Of a total of 1,273 beds across the acute and community hospital, 118
patients were on the dysphagia caseload. 13 patients were receiving oral
trials, 10 other patients had been on oral trials previously during
their stay and six patients were nil by mouth and had never been on oral
trials. No missing data was recorded during data collection. Patients
were seen across a range of specialisms and presented with a variety of
diagnoses (see table 1).
Comparisons between treatment groups (see table 2) show that patients on
oral trials were significantly more likely to have a neurological
diagnosis (78.3% vs 30.5%, p<0.001), be on a neurological
ward (69.6% vs 25.3%, p<0.001), live independently (73.9%
vs 42.1%, p=0.006) and were less likely to have dementia (17.4% vs
37.9%, p=0.027). There was a significant difference between age, with
individuals in the oral trials group being younger on average (66.70 vs
77.14 years old, p=0.003). The UK uses a pay banding system to grade the
levels of responsibilities of SLTs (range band 5-8), band 5 SLTs will
usually be newly qualified and have up to 5 years’ experience.
Individuals seen by Band 5 SLTs were more likely to be on full oral
intake (36.8% vs 8.7%, p=0.009), whilst those seen by mixed SLTs were
more likely to be on oral trials (65.2% vs 29.5%, p=0.001).
There was a considerable overlap between some variables measured.
Younger individuals were significantly more likely to live independently
(p<.001) and individuals with a neurological diagnosis were
significantly more likely to be on a neurological ward
(p<.001). Individuals with a neurological diagnosis were also
younger on average than those admitted for other reasons (68.45 vs
79.51, p<0.001).
Hierarchical logistical regression analysis shows that when neurological
diagnosis is included, age and being seen by mixed SLTs were no longer
significant predictors of being on oral trials (see table 3). Having a
neurological diagnosis was the key statistically significant contributor
to the model, with individuals with a neurological diagnosis being over
four times more likely to be on oral trials when controlled for age and
treating SLT. The model as a whole explained between 17.0% (Cox and
Snell R squared) and 27.2% (Nagelkerke R squared) of the variance in
treatment group and correctly classified 79.7% of cases.