Traumatic cervical spinal cord injury: a prospective clinical study of laryngeal penetration and aspiration

被引:23
|
作者
Ihalainen, T. [1 ,2 ]
Rinta-Kiikka, I. [3 ]
Luoto, T. M. [4 ]
Koskinen, E. A. [1 ]
Korpijaakko-Huuhka, A-M [2 ]
Ronkainen, A. [4 ]
机构
[1] Tampere Univ Hosp, Dept Neurosci & Rehabil, POB 2000, F-33521 Tampere, Finland
[2] Univ Tampere, Fac Social Sci, Tampere, Finland
[3] Tampere Univ Hosp, Pirkanmaa Hosp Dist, Med Imaging Ctr, Dept Radiol, Tampere, Finland
[4] Tampere Univ Hosp, Dept Neurosurg, Tampere, Finland
关键词
OROPHARYNGEAL DYSPHAGIA; SILENT ASPIRATION; INDIVIDUALS; CARE; VIDEOFLUOROSCOPY; COMPLICATIONS; DEGLUTITION; TETRAPLEGIA; PREVALENCE; IMPACT;
D O I
10.1038/sc.2017.71
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Study design: Prospective cohort study. Objectives: Dysphagia is a relatively common secondary complication in patients with traumatic cervical spinal cord injuries (TCSCI). The purpose of this study was to determine the incidence of aspiration and penetration in patients with acute TCSCI. Setting: Tampere University Hospital, Tampere, Finland. Methods: A total of 46 patients with TCSCI were evaluated with a videofluoroscopic swallowing study (VFSS). Rosenbek's penetration-aspiration scale (PAS) was used to classify the degree of penetration or aspiration. The medical records of each patient were systematically reviewed. Results: Of the 46 patients, 85% were male. The mean age at the time of the injury was 62.1 years. Most patients had an incomplete injury (78%), and most of them due to a fall (78%). In the VFSS 19 (41%) patients penetrated and 15 (33%) aspirated. Only 12 (26%) of the patients had a PAS score of 1 indicating that swallowed material did not enter the airway. Of the patients who aspirated, 73% had silent aspiration. Conclusion: The incidence of penetration or aspiration according to VFSS is high in this cohort of patients with TCSCI. Therefore, the swallowing function of patients with acute TCSCI should be routinely evaluated before initiating oral feeding. VFSS is highly recommended, particularly to rule out the possibility of silent aspiration and to achieve information on safe nutrition consistency.
引用
收藏
页码:979 / 984
页数:6
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