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  1. Swallowing disorders in severe brain injury : Risk factors affecting return to oral intake.

    Article - En anglais

    Objective 

    To determine the incidence and type of swallowing disorders that accompany severe brain injury and to identify factors that affect oral intake.

    Design 

    Inception cohort study.

    Setting 

    Level I trauma center.

    Patients 

    Consecutively admitted patients with severe brain injury who achieved cognitive levels during admission to assess swallowing and who did not sustain injuries preventing swallowing assessment (n=54).

    Main Outcome Measures 

    Type of swallowing abnormalities and presence of aspiration evident on videofluoroscopic swallow studies (VFSS), days to initiation and achievement of oral feeding, ventilation days, presence of a tracheostomy, and cognitive levels at initiation and achievement of oral feeding.

    Results 

    Sixty-one percent of subjects exhibited abnormal swallowing.

    Loss of bolus control and reduced lingual control occurred most commonly.

    Aspiration rate was 41%. Normal swallowers achieved oral feeding in 19 days versus 57 days for abnormal swallowers.

    Rancho Los Amigos (RLA) Level IV was needed for initiation of oral feeding ; Level VI was needed for total oral feeding.

    Risk factors for abnormal swallowing included : lower admission Glasgow Coma Scale (GCS) and RLA scores, presence of a tracheostomy, and ventilation time longer than 2 weeks.

    Risk factors for aspiration were lower admission GCS and RLA scores. (...)

    Mots-clés Pascal : Traumatisme, Crânioencéphalique, Indice gravité, Dysphagie, Complication, Diagnostic, Epidémiologie, Incidence, Symptomatologie, Facteur risque, Alimentation, Voie orale, Homme, Système nerveux pathologie, Système nerveux central pathologie, Encéphale pathologie, Système ostéoarticulaire pathologie, Crâne pathologie, Appareil digestif pathologie, Oesophage pathologie

    Mots-clés Pascal anglais : Trauma, Craniocerebral, Severity score, Dysphagia, Complication, Diagnosis, Epidemiology, Incidence, Symptomatology, Risk factor, Feeding, Oral administration, Human, Nervous system diseases, Central nervous system disease, Cerebral disorder, Diseases of the osteoarticular system, Skull disease, Digestive diseases, Esophageal disease

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 99-0253432

    Code Inist : 002B16B. Création : 16/11/1999.