Factors affecting oral feeding with severe traumatic brain injury.
Safe and adequate nutrition, vital to the recovery from a traumatic brain injury, can be severely compromised by the presence of dysphagia. This study identified injury severity and swallowing factors that were associated with impaired oral intake in patients with severe brain injury. An admitting Glasgow Coma Scale (GSC) 3-5; a Rancho Los Amigos Scale of Cognitive Functioning (RLA) Level II; a computed tomography (CT) scan exhibiting midline shift, brainstem involvement, or brain pathology requiring emergent operative procedures; or ventilation time >/=15 days identified patients at highest risk for abnormal swallowing, aspiration, and delay in initiation of oral feeding and achievement of total oral feeding. When combined in multivariate models, RLA Level, CT scan, ventilation time and aspiration emerged as significant independent predictors of impaired oral intake.
Mackay
L E
LE
Rehabilitation Medicine, Medical/Surgical Program, Saint Francis Hospital and Medical Center, Hartford, Connecticut 06105, USA.
Morgan
A S
AS
Bernstein
B A
BA
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000704:Analysis of Variance; D001930:Brain Injuries / Q000145:classification / Q000150:complications* / Q000175:diagnosis / Q000628:therapy*; D003071:Cognition; D003680:Deglutition Disorders / Q000175:diagnosis* / Q000209:etiology*; D004750:Enteral Nutrition / Q000009:adverse effects* / Q000379:methods*; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D012121:Respiration, Artificial; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D014057:Tomography, X-Ray Computed