Dysphagia in Traumatic Brain Injured Patients

ABSTRACT

OBJECTIVE: To investigate the frequency and nature of dysphagia of traumatic brain injured (TBI) patients, and to examine the relationship of clinical parameters with the dysphagia. METHOD: Forty-two TBI patients were included in this study. We examined clinical parameters such as Glasgow coma scale (GCS), duration of coma, and posttraumatic amnesia (PTA), hospital stay, rehabilitation stay, functional independence measure (FIM) gain, and efficiency as functional outcomes. We classified the brain lesions into two categories focal and nonfocal lesion according to the findings of the brain CT imaging. We performed videofluoroscopic swallowing study (VSS) for patients with dysphagia. RESULTS: Eighteen (42.8%) out of total 42 TBI patients had dysphagia. The presence of dysphagia had significant relationship with GCS, duration of PTA, hospital and rehabilitation stay, and FIM gain. Duration of dysphagia was positively correlated with duration of coma, and hospital and rehabilitation stay, but negatively correlated with FIM gain and efficiency. Duration of dysphagia was longer in patients with nonfocal brain lesion than those with focal brain lesion. On VSS findings, common problems were impairment of tongue control and prolonged pharyngeal transit time. Majority of patients had combined problems in oral and pharyngeal phases. CONCLUSION: Dysphagia was common problem in TBI patients, and occurrence and duration were correlated with several clinical parameters and with prognosis of TBI patients.