Predictors of swallowing outcomes in patients with combat-injury related dysphagia.

Background: Traumatic injuries, such as those from combat-related activities, can lead to complicated clinical presentations that may include dysphagia.Methods: This retrospective observational database study captured dysphagia-related information for 215 US military service members admitted to the...

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Publicado en:Journal of Trauma & Acute Care Surgery Vol. 89; pp. 192 - 200
Autores principales: Solomon, Nancy Pearl, Dietsch, Angela M., Dietrich-Burns, Katie
Formato: research tables/charts Journal Article
Publicado: Lippincott Williams & Wilkins 2020 Supplement
Acceso en línea:Ver este registro en EBSCOhost
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      dt: 2020 Supplement
      vid: 89
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      pub: Lippincott Williams & Wilkins
      place: Baltimore, Maryland
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        atl: Predictors of swallowing outcomes in patients with combat-injury related dysphagia.
      aug:
        au:
          Solomon, Nancy Pearl
          Dietsch, Angela M.
          Dietrich-Burns, Katie
        affil: Walter Reed National Military Medical Center, Bethesda, MD.
      sug:
        subj:
          Maxillofacial Injuries Complications
          Deglutition Disorders Etiology
          Military Personnel
          Deglutition
          Retrospective Design
          Resource Databases
          United States
          Human
          Speech Disorders Etiology
          Probability
          Analysis of Variance
          Young Adult
          Speech Disorders Therapy
          Deglutition Disorders
          Treatment Outcomes
          Military Medicine
          Adult
          Middle Age
          Validation Studies
          Comparative Studies
          Evaluation Research
          Multicenter Studies
          Adult: 19-44 years
          Middle Aged: 45-64 years
      ab: Background: Traumatic injuries, such as those from combat-related activities, can lead to complicated clinical presentations that may include dysphagia.Methods: This retrospective observational database study captured dysphagia-related information for 215 US military service members admitted to the first stateside military treatment facility after sustaining combat-related or combat-like traumatic injuries. A multidimensional relational database was developed to document the nature, course, and management for dysphagia in this unique population and to explore variables predictive of swallowing recovery using Bayesian statistical modeling and inferential statistical methods.Results: Bayesian statistical modeling revealed the importance of maxillofacial fractures and soft tissue loss as primary predictors of poor swallowing outcomes. The presence of traumatic brain injury (TBI), though common, did not further complicate dysphagia outcomes. A more detailed examination and rating of videofluoroscopic swallow studies from a subset of 161 participants supported greater impairment for participants with maxillofacial trauma and no apparent relationship between having sustained a TBI and swallow functioning.Conclusion: These analyses revealed that maxillofacial trauma is a stronger indicator than TBI of dysphagia severity and slower or incomplete recovery following combat-related injuries.Level Of Evidence: Therapeutic/Care Management study, level IV.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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