Incidence of dysphagia-related safety incidents in older adults across feeding methods: A systematic review and meta-analysis

Objective: Dysphagia-related safety incidents encompass near-miss events, no-harm occurrences, or harmful incidents associated with oral or enteral feeding methods. This systematic review and meta-analysis aimed to assess the incidence rates of dysphagia-related safety incidents in older adults acro...

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Main Authors: Yingying Zhang, Zhina Gong, Jianzheng Cai, Weixia Yu, Yinuo Dai, Haifang Wang
Format: Article
Language:English
Published: Elsevier 2025-05-01
Series:The Journal of Nutrition, Health and Aging
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Online Access:http://www.sciencedirect.com/science/article/pii/S1279770725000454
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author Yingying Zhang
Zhina Gong
Jianzheng Cai
Weixia Yu
Yinuo Dai
Haifang Wang
author_facet Yingying Zhang
Zhina Gong
Jianzheng Cai
Weixia Yu
Yinuo Dai
Haifang Wang
author_sort Yingying Zhang
collection DOAJ
description Objective: Dysphagia-related safety incidents encompass near-miss events, no-harm occurrences, or harmful incidents associated with oral or enteral feeding methods. This systematic review and meta-analysis aimed to assess the incidence rates of dysphagia-related safety incidents in older adults across various feeding methods. Methods: A comprehensive literature search was conducted using PubMed, Embase, Web of Science, Cochrane Library, and CINAHL databases to identify studies reporting dysphagia-related safety incidents in older adults. The feeding methods analyzed included oral feeding, nasogastric (NG) tube feeding, and percutaneous endoscopic gastrostomy (PEG) tube feeding. Randomized controlled trials (RCTs), non-randomized studies, and cohort studies were included. The analysis adhered to the PRISMA guidelines, and meta-analytic outcomes were presented with 95% confidence intervals (CIs). Results: A total of 30 studies satisfied the inclusion criteria. The overall incidence rates of safety incidents were 13.8% for oral feeding, 23.9% for NG tube feeding, and 26.5% for PEG tube feeding. Aspiration pneumonia emerged as the most prevalent safety incident across all feeding methods, with incidence rates of 12.0% for oral feeding, 20.6% for NG tube feeding, and 12.4% for PEG tube feeding. Tube feeding methods were associated with diarrhea and wound infection. Additionally, specialized safety incidents were observed for each feeding method: suffocation in oral feeding; gastroesophageal reflux in NG tube feeding; and tube blockage, tube dislodgment, tube leakage, vomiting, nausea, site pain, gastrointestinal hemorrhage, and peritonitis in PEG tube feeding. Conclusions: Dysphagia-related safety incidents in older adults demonstrated considerable variability in type and frequency across different feeding methods. Understanding these differences could provide healthcare professionals with valuable insights for targeted risk prediction and proactive management strategies to mitigate such incidents.
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spelling doaj-art-96bdd0d5ea3f4f5fb6b9c6e44ef033792025-08-20T03:52:06ZengElsevierThe Journal of Nutrition, Health and Aging1760-47882025-05-0129510052210.1016/j.jnha.2025.100522Incidence of dysphagia-related safety incidents in older adults across feeding methods: A systematic review and meta-analysisYingying Zhang0Zhina Gong1Jianzheng Cai2Weixia Yu3Yinuo Dai4Haifang Wang5Department of Radiotherapy, The First Affiliated Hospital of Soochow University, Suzhou, ChinaThe First Affiliated Hospital of Soochow University, Suzhou, ChinaDepartment of Nursing, The First Affiliated Hospital of Soochow University, Suzhou, China; Corresponding authors.Department of Critical Medicine, The First Affiliated Hospital of Soochow University, Suzhou, ChinaThe First Affiliated Hospital of Soochow University, Suzhou, ChinaDepartment of Nursing, The First Affiliated Hospital of Soochow University, Suzhou, China; Corresponding authors.Objective: Dysphagia-related safety incidents encompass near-miss events, no-harm occurrences, or harmful incidents associated with oral or enteral feeding methods. This systematic review and meta-analysis aimed to assess the incidence rates of dysphagia-related safety incidents in older adults across various feeding methods. Methods: A comprehensive literature search was conducted using PubMed, Embase, Web of Science, Cochrane Library, and CINAHL databases to identify studies reporting dysphagia-related safety incidents in older adults. The feeding methods analyzed included oral feeding, nasogastric (NG) tube feeding, and percutaneous endoscopic gastrostomy (PEG) tube feeding. Randomized controlled trials (RCTs), non-randomized studies, and cohort studies were included. The analysis adhered to the PRISMA guidelines, and meta-analytic outcomes were presented with 95% confidence intervals (CIs). Results: A total of 30 studies satisfied the inclusion criteria. The overall incidence rates of safety incidents were 13.8% for oral feeding, 23.9% for NG tube feeding, and 26.5% for PEG tube feeding. Aspiration pneumonia emerged as the most prevalent safety incident across all feeding methods, with incidence rates of 12.0% for oral feeding, 20.6% for NG tube feeding, and 12.4% for PEG tube feeding. Tube feeding methods were associated with diarrhea and wound infection. Additionally, specialized safety incidents were observed for each feeding method: suffocation in oral feeding; gastroesophageal reflux in NG tube feeding; and tube blockage, tube dislodgment, tube leakage, vomiting, nausea, site pain, gastrointestinal hemorrhage, and peritonitis in PEG tube feeding. Conclusions: Dysphagia-related safety incidents in older adults demonstrated considerable variability in type and frequency across different feeding methods. Understanding these differences could provide healthcare professionals with valuable insights for targeted risk prediction and proactive management strategies to mitigate such incidents.http://www.sciencedirect.com/science/article/pii/S1279770725000454Safety incidentsDysphagiaFeedingIncidenceOlder adults
spellingShingle Yingying Zhang
Zhina Gong
Jianzheng Cai
Weixia Yu
Yinuo Dai
Haifang Wang
Incidence of dysphagia-related safety incidents in older adults across feeding methods: A systematic review and meta-analysis
The Journal of Nutrition, Health and Aging
Safety incidents
Dysphagia
Feeding
Incidence
Older adults
title Incidence of dysphagia-related safety incidents in older adults across feeding methods: A systematic review and meta-analysis
title_full Incidence of dysphagia-related safety incidents in older adults across feeding methods: A systematic review and meta-analysis
title_fullStr Incidence of dysphagia-related safety incidents in older adults across feeding methods: A systematic review and meta-analysis
title_full_unstemmed Incidence of dysphagia-related safety incidents in older adults across feeding methods: A systematic review and meta-analysis
title_short Incidence of dysphagia-related safety incidents in older adults across feeding methods: A systematic review and meta-analysis
title_sort incidence of dysphagia related safety incidents in older adults across feeding methods a systematic review and meta analysis
topic Safety incidents
Dysphagia
Feeding
Incidence
Older adults
url http://www.sciencedirect.com/science/article/pii/S1279770725000454
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