Abstract Details

IBM is the most common idiopathic inflammatory myopathy (IIM) found in patients 50 years and older. It predominantly affects the long finger flexors and knee extensors, and IBM also leads to swallowing dysfunction in about 40-80% of patients. While the pattern and burden of muscle weakness in IBM are well recognized, the burden of dysphagia has received limited attention.

We assessed the burden of dysphagia in patients with inclusion body myositis (IBM) as compared to patients with dermatomyositis (DM) and polymyositis (PM) by examining the in-hospital dysphagia-related complications with the National Inpatient Sample (NIS) database.

We identified patients from the NIS database with a primary diagnosis of IBM, DM, or PM admitted to the hospital between 2012 and 2018. We explored the frequency of complicating events related to swallowing dysfunction during the admission, such as aspiration pneumonia and percutaneous endoscopic gastrostomy (PEG) tube placement.

A total of 18,819 patients with either IBM, DM, or PM were admitted during this period. Patients with IBM were older (72.9 +/- 10.7 years, vs. 59.3 +/- 18.4 years for DM/PM, p <0.001), with men being more commonly affected (65.0% vs. 31.2% for DM/PM, p<0.001). The majority of the IBM patients were White Caucasians (82.5% vs. 58.4% for DM/PM, p<0.001). Aspiration pneumonia (14.3% vs. 3.6% in DM/PM, p < 0.001) and PEG tube (6.6% vs. 2.1% in DM/PM, p < 0.001) placement were more frequent among IBM patients. IBM increased the risk for an aspiration event (Odds Ratio (OR) 3.0, CI 2.6-3.6) or a PEG tube placement (OR 2.9, CI 2.3-3.6) when compared to DM/PM.

Dysphagia related in-hospital complication is more frequent in patients with IBM compared to other IIMs. Large-scale longitudinal studies examining the characteristic pattern of dysphagia and exploring the burden of dysphagia in IBM are warranted.