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Patterns and Predictors of Swallowing Resolution Following Adult Traumatic Brain Injury

Ward, Elizabeth C. PhD; Green, Karly BSpPath(Hons); Morton, Ann-Louise BSpPath(Hons)

Section Editor(s): Caplan, Bruce PhD, ABPP, Issue Editor

Journal of Head Trauma Rehabilitation: May-June 2007 - Volume 22 - Issue 3 - p 184–191
doi: 10.1097/01.HTR.0000271119.96780.f5
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Objective To examine the patterns of swallowing resolution and outcomes of traumatic brain injury (TBI) patients in an acute care setting and document the risk factors or predictors of resolution of swallowing function.

Participants 117 consecutive TBI patients who had received speech pathology intervention for dysphagia during acute postinjury care.

Main outcome measure Temporal measures relating to pattern of resolution of dysphagia postinjury.

Results 75% of patients were assessed by 2 weeks postinjury, commenced oral intake by 17 days, and ceased supplementation by 3 weeks. By an average of 22 days after admission, 47% had progressed to normal-consistency diet and fluids. Duration to the first swallowing assessment was a predictor for achieving total oral intake and returning to normal intake. There was some preliminary support for severity of CT data and presence/absence of a tracheostomy as predictors for return to normal intake.

Conclusion The current data document the natural history of swallowing resolution and proposes prognostic factors for patients with impaired swallowing following TBI. Establishing clinical parameters that can help predict patterns of swallowing resolution over the course of acute care admission may greatly assist inpatient management and discharge/rehabilitation planning.

Division of Speech Pathology, School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia (Dr Ward and Ms Green); and the Speech Pathology Department, Royal Brisbane & Women's Hospital, Brisbane, Australia (Ms Morton).

Corresponding author: Elizabeth C. Ward, PhD, Division of Speech Pathology, Therapies Bldg, The University of Queensland, St Lucia 4072, Australia (e-mail: liz.ward@uq.edu.au).

The authors acknowledge the support of the Neurosurgery wards and Speech Pathology and Medical Records Departments at the Royal Brisbane and Women's Hospital, and Dr Ross Darnell, Senior Statistician, University of Queensland.

© 2007 Lippincott Williams & Wilkins, Inc.