[Deglutition disorders in neurological patients. A prospective study of diagnosis, pattern of impairment, therapy and outcome].
We performed a prospective study on 208 patients with neurogenic dysphagia who were consecutively admitted for swallowing therapy over a 3-year period. The most frequent etiology was stroke (48%). Videofluoroscopic and/or fiber optic endoscopic evaluation of swallowing were performed in 204 patients. Swallowing therapy was comprised of restitution methods, compensation, and adaptation, each of which was applied in more than 80% of the patients. Mean duration of swallowing therapy was 2 months (full oral patients 1 month, patients dependent on tube feeding or tracheostomy 2.5 and 3.5 months, respectively). Fifty-five percent of the patients initially dependent on tube feeding were full oral feeders after swallowing therapy. A target variable reflecting functional feeding status showed significant improvement after swallowing therapy, also in patients with a disease duration of more than half a year, ruling out spontaneous recovery as a sole explanation of amelioration. The following variables were the main contributors to outcome prediction: functional feeding status, Barthel index, duration of disease, and degree of aspiration as shown by endoscopy.
Prosiegel
M
M
Neurologisches Krankenhaus München, Tristanstrasse 20, 80804 München. prosiegel-nkm@t-online.de
Heintze
M
M
Wagner-Sonntag
E
E
Hannig
C
C
Wuttge-Hannig
A
A
Yassouridis
A
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001927:Brain Diseases / Q000150:complications* / Q000175:diagnosis / Q000209:etiology; D003131:Combined Modality Therapy; D003680:Deglutition Disorders / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination; D011379:Prognosis; D011446:Prospective Studies; D016896:Treatment Outcome