<b>Clinical Profile of Patients Presenting with Dysphagia in the Emergency Department</b>

Background: Dysphagia is an important emergency department presentation associated with aspiration, pneumonia, malnutrition, prolonged hospitalization, and increased morbidity, particularly among older adults and patients with neurological disease. Objective: To determine the clinical profile, etiological distribution, associated comorbidities, and aspiration-related complications among adult patients presenting with dysphagia in the emergency department of a tertiary care hospital. Methods: This retrospective observational study was conducted in the emergency department of Lady Reading Hospital, Peshawar, from 1 November 2025 to 30 January 2026. A total of 120 patients aged 18 years and above with documented swallowing difficulty were included. Demographic characteristics, symptom pattern, duration of dysphagia, etiology, comorbidities, and aspiration-related complications were extracted from medical records. Data were analyzed using SPSS version 26. Categorical variables were compared using chi-square test, and mean age between groups was compared using independent sample t-test, with p≤0.05 considered significant. Results: The mean age was 56.8±17.2 years, and 72 patients (60.0%) were male. Neurological causes were most frequent, affecting 58 patients (48.3%), with stroke accounting for 44 cases (36.7%). Structural causes were identified in 34 patients (28.3%). Neurological dysphagia was significantly associated with age above 50 years (p=0.01), and patients with neurological dysphagia had a higher mean age than those with non-neurological causes (61.2±14.5 vs 52.3±18.6 years; p=0.02). Aspiration-related complications occurred in 26 patients (21.7%), including aspiration pneumonia in 18 patients (15.0%), and were significantly more frequent in neurological dysphagia (p=0.03). Conclusion: Dysphagia in the emergency department predominantly affected older adults and was most commonly neurological in origin, with stroke as the leading specific cause. Early dysphagia screening and aspiration-risk assessment are essential in emergency neurological presentations.