Citation

Rumbach AF, Ward EC, Cornwell PL, Bassett LV, Khan A, Muller MJ. J. Burn Care Res. 2011; 32(6): 608-616.

Affiliation

Division of Speech Pathology, School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Australia; Centre for Functioning and Health Research (CFAHR), Queensland Health, Australia; Metro North Health Service District, Queensland Health, Australia; School of Psychology, Griffith University, Mt Gravatt, Queensland, Australia; Speech Pathology Department, Royal Brisbane & Women's Hospital, Queensland, Australia; ¶School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Australia; Stuart Pegg Adult Burns Centre, Royal Brisbane & Women's Hospital, Queensland, Australia; and Burns, Trauma and Critical Care Research Centre, University of Queensland, Brisbane, Australia.

Copyright

(Copyright © 2011, American Burn Association, Publisher Lippincott Williams and Wilkins)

DOI

10.1097/BCR.0b013e318231c126

PMID

21918467

Abstract

The objective of this study is to determine dysphagia incidence for a consecutively admitted population of thermal burn injury cases and to determine admitting characteristics that can be used to reliably predict patients at risk of developing dysphagia after thermal burn. Four hundred thirty-eight patients with thermal burns, with or without inhalation injury, who were consecutively admitted to and received management at a state-wide burn center over a 2-year period (2007-2009) were included. All patients meeting the project's inclusion criteria underwent clinical swallowing assessment to determine the presence/absence of dysphagia. Dysphagia incidence was found to be 11.18% (n = 49) in the admitted population. Dysphagia severity at initial assessment was classified as severe for 40.82%, moderate for 30.61%, and mild for 28.57%. Statistical analysis revealed a core set of statistically significant parameters known within the first 24 hours postinjury which showed strong sensitivity and specificity for detection of dysphagia risk. These include, in isolation or in combination, with the consideration of increasing age, TBSA burnt ≥18%, head and neck burns, need for escharotomy, inhalation injury, need for intensive care admission, and need for mechanical ventilation. This is the first large prospective cohort study to document dysphagia incidence within the thermal burn population and to validate key predictors for dysphagia risk in this population. These data will assist the allocation and planning of speech pathology services and provide an evidence-based pathway for ensuring early identification and management of patients at high risk of dysphagia after thermal burn injury.

Language: en