Prevalence and Clinical Characteristics of Dysphagia Among Patients Attending Otolaryngology Clinics: A Cross-Sectional Study

Abstract

Background: Dysphagia is associated with nutritional, respiratory, and quality-of-life burden, yet nationally representative evidence describing its presentation in office-based otolaryngology is limited. This study estimated the prevalence of documented dysphagia-related otolaryngology visits and characterized associated patient and encounter features.
Methods: A cross-sectional secondary analysis used the 2015 National Ambulatory Medical Care Survey. Otolaryngology visits were identified by physician specialty. Dysphagia was defined by a reason-for-visit code for difficulty swallowing, an ICD-9-CM 787.2x diagnosis, or either criterion. Analyses incorporated national visit weights, masked strata, and provider clusters; Taylor-series linearization was used for uncertainty estimation.
Results: Among 2,487 sampled otolaryngology visits, 83 met the primary dysphagia definition. Survey-weighted prevalence was 3.82% (95% CI, 2.35%-6.16%), representing approximately 947,000 visits; reason-for-visit and diagnosis-only prevalence estimates were 2.46% and 2.34%, respectively. Dysphagia-related visits involved older patients than other visits (mean age, 60.0 vs. 48.0 years; p < .001), and 53.5% versus 31.2% involved patients aged 65 years or older (p = .002). Cancer was more frequent in dysphagia-related visits (27.7% vs. 8.1%; p = .002) and remained associated after adjustment for age and sex (adjusted odds ratio, 3.21; 95% CI, 1.41-7.29). Chronic-condition counts were higher before adjustment, whereas physician contact time was not significantly different. Conclusion: Documented dysphagia occurred in approximately one in 26 nationally represented office-based otolaryngology visits. Older age and cancer characterized the dysphagia visit population; however, sparse neurologic indicators, routine coding, and the visit-level cross-sectional design require cautious interpretation.