Predictors of dysphagia after spinal cord injury

Kirshblum, Steven; Johnston, Mark V.; Brown, Joe R.; O’Connor, Kevin; Jarosz, Paul

doi:10.1016/s0003-9993(99)90068-0

Cited by 111 publications

(115 citation statements)

References 28 publications

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“…Those studies, which have been carried out, have been retrospective and have collected potential trigger factors. Kirshblum et al 6 showed that, in addition to factors such as age, surgical approach and ventilation, tracheotomized patients had a particularly high risk of developing swallowing disorder. A study by Abel was able to confirm, with the exception of age, the effect of these factors.…”

Section: Discussionmentioning

confidence: 99%

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Dysphagia in acute tetraplegics: a retrospective study

Seidl

Nusser-Müller-Busch

et al. 2009

Spinal Cord

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Study design: Retrospective study. Objectives: Swallowing disorder in patients with tetraplegia represents a problem. Incidence and clinical data were examined to determine the influencing factors. Setting: Level I trauma Center, Berlin, Germany. Method: Retrospective study (1 September 1997-31 December 2002) on hospitalized patients with acute tetraplegia. The patients' swallowing ability was examined both clinically and endoscopically, and the results correlated with clinical data. Results: A total of 175 patients (144 (82.29%) male patients and 31 (17.71%) female patients (4.6:1) were studied. The peak age groups (43.45, ± 18.98, 14-89 years) were 20-30 years and over 60 years. C4-C6 were most commonly affected. Tetraplegia was trauma-related in 147 (84%) patients. Twentyeight (16.0%) patients appeared to be suffering from a swallowing disorder on first feeding, 23 (82.14%) patients with dysphagia were tracheotomized. The level of tetraplegia (w 2 ¼ 19.8; Po0.05), tracheotomy (w 2 ¼ 21.7; Po0.05) and the duration of ventilation (w 2 ¼ 24.84, Po0.05) were all found to be statistically significant factors in the development of a swallowing disorder. Age, surgical approach, level of tetraplegia, severity of paralysis and the need for tracheotomy were predictive of dysphagia in 73.14% patients. Five patients with dysphagia died (because of causes other than dysphagia) and 10 patients were discharged with a feeding tube. Conclusion: No single trigger for a swallowing disorder in acute tetraplegia was found. A combination of multiple factors (level of tetraplegia, severity of paralysis, tracheotomy, accompanying injuries and accompanying illnesses) restricts swallowing and compensation of changes, to the extent that a swallowing disorder becomes apparent.

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Section: Discussionmentioning

confidence: 99%

“…Various previous studies have identified a correlation between tracheotomy and dysphagia in tetraplegic patients. 6,7 We carried out a retrospective study to examine swallowing ability after injuries to the cervical spine involving injury to the spinal cord and its possible causes and correlates.…”

Section: Introductionmentioning

confidence: 99%

Dysphagia in acute tetraplegics: a retrospective study

Seidl

Nusser-Müller-Busch

et al. 2009

Spinal Cord

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“…The association of mechanical ventilation with risk of pneumonia is well known, and this study confirmed pneumonia and other respiratory diseases as the most common cause of death for these patients. Aspiration should also be considered as a possible contributor to the risk for pneumonia in this patient population, given the increased risk of aspiration in patients with mechanical ventilation and tracheostomy (37). While the NSCISC database does not include information on the incidence of dysphagia and the method of alimentation, it should be assumed that individuals with high-level tetraplegia are at risk.…”

Section: Other Considerationsmentioning

confidence: 99%

Long-Term Survival of Persons Ventilator Dependent After Spinal Cord Injury

Shavelle¹,

DeVivo

Strauss³

et al. 2006

The Journal of Spinal Cord Medicine

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Background/Objective: Identify factors related to long-term survival, and quantify their effect on mortality and life expectancy.Setting: Model spinal cord injury systems of care across the United States.Study Design: Survival analysis of persons with traumatic spinal cord injury who are ventilator dependent at discharge from inpatient rehabilitation and who survive at least 1 year after injury.Methods: Logistic regression analysis on a data set of 1,986 person-years occurring among 319 individuals injured from 1973 through 2003. Results:The key factors related to long-term survival were age, time since injury, neurologic level, and degree of completeness of injury. The life expectancies were modestly lower than previous estimates. Pneumonia and other respiratory conditions remain the leading cause of death but account for only 31% of deaths of known causes.Conclusions: Whereas previous research has suggested a dramatic improvement in survival over the last few decades in this population, this is only the case during the critical first few years after injury. There was no evidence for such a trend in the subsequent period.

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“…In the past, several studies investigated dysphagia in spinal cord injury patients. Kirshblum et al 7 reported that in their study cord injury underwent bedside swallow evaluation and 32 patients who were suspected to have dysphagia were further tested with VFSS. Dysphagia was detected in 26 patients and incidence of pneumonia in these patients at least 2 weeks after the initial injury was found to be significantly higher than in the remaining patients.…”

Section: Introductionmentioning

confidence: 99%

Dysphagia in cervical spinal cord injury

et al. 2011

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Results: A total of 121 cervical spinal cord injury patients (106 male and 16 female patients) were included in this study. Ten patients showed evidence of aspiration on VFSS. Statistical correlation to aspiration was found with age, presence of tracheostomy, and symptoms and signs indicating dysphagia. However, out of the 10 patients with evident aspiration, 2 patients did not show any symptoms or signs indicating aspiration. Conclusion: Because of the possibility of silent aspiration, we recommend that physicians treating patients with cervical spinal cord injury should always take the possibility of dysphagia and silent aspiration into consideration, especially in case of previous manifestation of pneumonia, presence of tracheostomy, or presence of signs and symptoms indicating dysphagia.

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Predictors of dysphagia after spinal cord injury

Cited by 111 publications

References 28 publications

Dysphagia in acute tetraplegics: a retrospective study

Dysphagia in acute tetraplegics: a retrospective study

Long-Term Survival of Persons Ventilator Dependent After Spinal Cord Injury

Dysphagia in cervical spinal cord injury

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