Incidence, characteristics, and predictive factors for dysphagia after pediatric traumatic brain injury

Morgan, Angela, Ward, Elizabeth, Murdoch, Bruce, Kennedy, Bronwyn and Murison, Robert (2003) Incidence, characteristics, and predictive factors for dysphagia after pediatric traumatic brain injury. Journal of Head Trauma Rehabilitation, 18 3: 239-251. doi:10.1097/00001199-200305000-00002


Author Morgan, Angela
Ward, Elizabeth
Murdoch, Bruce
Kennedy, Bronwyn
Murison, Robert
Title Incidence, characteristics, and predictive factors for dysphagia after pediatric traumatic brain injury
Journal name Journal of Head Trauma Rehabilitation   Check publisher's open access policy
ISSN 0885-9701
Publication date 2003-05
Sub-type Article (original research)
DOI 10.1097/00001199-200305000-00002
Volume 18
Issue 3
Start page 239
End page 251
Total pages 13
Editor Bruce Murdoch
Place of publication USA
Publisher Lippincott Williams & Wilkins
Collection year 2003
Language eng
Subject C1
321025 Rehabilitation and Therapy - Hearing and Speech
730111 Hearing, vision, speech and their disorders
730303 Occupational, speech and physiotherapy
Abstract Objective: (1) To establish an incidence figure for dysphagia in a population of pediatric traumatic brain injury (TBI) cases; (2) to provide descriptive data on the admitting characteristics, patterns of resolution, and outcomes of children with and without dysphagia after TBI; and (3) to identify any factors present at admission that may predict dysphagia. Participants: A total of 1, 145 children consecutively admitted to an acute care setting for traumatic brain injury between July 1995 and July 2000. Main outcome measure: Medical parameters relating to dysphagia based on medical chart review. Results: (1) Dysphagia incidence figure of 5.3% across all pediatric head injury admissions. Incidence figures of 68% for severe TBI, 15% for moderate TBI, and only 1% for mild brain injury. (2) Statistically significant differences were found between the dysphagic and nondysphagic subgroups on the variables of length of stay, length of ventilation, Glasgow Coma Scale (GCS), computed tomography classification, duration of speech pathology intervention, supplemental feeding duration, duration until initiation of oral intake (DIOF), duration to total oral intake (DTOF), and period of time from the initiation of intake until achievement of total oral intake (DI-TOF). (3) Significant predictive factors for dysphagia included GCS < 8.5 and a ventilation period in excess of 1.5 days. Conclusion: The provision of incidence data and predictive factors for dysphagia will enable clinicians in acute care settings to allocate resources necessary to deal with the predicted number of dysphagia cases in a pediatric population, and assist in predicting patients who are at risk for dysphagia following TBI. Early detection of patients with swallowing dysfunction will be aided by these data, in turn helping to facilitate effective medical and speech pathology intervention via assisting the reduction of medical complications such as aspiration pneumonia.
Keyword Rehabilitation
Brain Injury
Dysphagia
Incidence
Outcomes
Pediatric
Head-injury
Swallowing Disorders
Health-care
Complications
Children
Adults
Management
Emergency
Ebm
Q-Index Code C1

 
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Created: Tue, 14 Aug 2007, 19:16:50 EST