Dehydration and swallowing problems linked to hospital deaths
In German geriatric admissions, in-hospital mortality was 12.1% with both conditions, compared with 2.2% with neither.
An observational registry study analysed 1,343,561 acute geriatric hospital admissions of people aged 65 or older in Germany between 2006 and 2024. Researchers identified dehydration and dysphagia, or difficulty swallowing, from recorded diagnosis codes. Dehydration was documented in 13.2% of admissions. Mortality was 5.8% in admissions with dehydration versus 2.6% without it.
Dehydration remained associated with death in hospital after accounting for swallowing difficulties and other factors. Swallowing difficulties also remained independently associated with death. Mortality was 2.2% with neither condition, 4.7% with dehydration alone, 8.6% with swallowing difficulties alone and 12.1% with both. Admissions with both conditions had the highest adjusted odds of death.
Why it matters
For older people in acute geriatric care, the findings support considering swallowing and hydration together in clinical care.
Caveats
This observational registry study cannot show that dehydration or swallowing difficulties caused deaths. Researchers identified both conditions from recorded diagnosis codes.
From the paper
- Participants
The main multivariable mortality model included 1,316,204 complete cases (98.0% of the primary analysis population).
Results, Independent associations with in-hospital mortality
- Result
After adjustment including dysphagia, dehydration remained independently associated with in-hospital death (adjusted OR 1.35, 95% CI 1.32–1.38), as did dysphagia (adjusted OR 1.68, 95% CI 1.64–1.73).
- Limitation
Dehydration and dysphagia were identified through routine ICD-10-GM coding, while laboratory measures of hydration, standardized dysphagia assessments, information on clinical or instrumental confirmation of dysphagia, and diagnostic timing and severity were unavailable.
Quoted word for word from the full text on link.springer.com.
The paper
Marien Hospital Herne
European Geriatric Medicine, 12 Oct 2026
