Hospitalized patients are often at increased risk for oropharyngeal dysphagia following
prolonged endotracheal intubation. Although reported incidence can be high, it varies
widely. We conducted a systematic review to determine: (1) the incidence of dysphagia
following endotracheal intubation, (2) the association between dysphagia and intubation
time, and (3) patient characteristics associated with dysphagia. Fourteen electronic
databases were searched, using keywords dysphagia, deglutition disorders, and intubation,
along with manual searching of journals and grey literature. Two reviewers, blinded
to each other, selected and reviewed articles at all stages according to our inclusion
criteria: adult participants who underwent intubation and clinical assessment for
dysphagia. Exclusion criteria were case series (n < 10), dysphagia determined by patient
report, patients with tracheostomies, esophageal dysphagia, and/or diagnoses known
to cause dysphagia. Critical appraisal used the Cochrane risk of bias assessment and
Grading of Recommendations, Assessment, Development and Evaluation tools. A total
of 1,489 citations were identified, of which 288 articles were reviewed and 14 met
inclusion criteria. The studies were heterogeneous in design, swallowing assessment,
and study outcome; therefore, we present findings descriptively. Dysphagia frequency
ranged from 3% to 62% and intubation duration from 124.8 to 346.6 mean hours. The
highest dysphagia frequencies (62%, 56%, and 51%) occurred following prolonged intubation
and included patients across all diagnostic subtypes. All studies were limited by
design and risk of bias. Overall quality of the evidence was very low. This review
highlights the poor available evidence for dysphagia following intubation and hence
the need for high-quality prospective trials.