[Dysphagia--an overlooked problem in neurorehabilitation].
BACKGROUND
The purpose of this study was to evaluate the management of dysphagia in patients with traumatic brain injury (TBI) and adjoining disorders during multidisciplinary neurorehabilitation in phase I and II in Denmark and abroad.


METHODS
The study was conducted as structured interviews at six outstanding international neurorehabilitation institutions and as a national questionnaire survey including five phase I neurointensive wards and two phase II neurorehabilitation institutions.


RESULTS
Data from the study visits showed that the international clinics received patients with cuffed tracheostomy tubes, had 24-hour medical support, and semiintensive monitoring. Patients were treated by multidisciplinary teams and all were clinically and instrumentally examined for dysphagia. Data from the Danish questionnaire survey showed that the two neurorehabilitation institutions did not receive patients with cuffed tracheostomy tubes. Both institutions had 24-hour medical support, multidisciplinary teams and monitoring of saturation. Clinical and instrumental examinations of dysphagia were not systematic procedures in either phase I or II.


CONCLUSIONS
The study demonstrates the need for clinical guidelines on the examination and treatment of dysphagia in patients with TBI and adjoining disorders within neurorehabilitation in phase I and II in Denmark. There is also a need to clarify the management of dysphagia in patients with cuffed tracheostomy tubes.
Kjaersgaard
Annette
A
Hammel Neurocenter og Arhus Universitetshospital, Arhus Sygehus, Neurokirurgisk Afdeling. neuak@sc.aaa.dk
Langhorn
Leanne
L
D001930:Brain Injuries / Q000150:complications / Q000534:rehabilitation*; D003680:Deglutition Disorders / Q000175:diagnosis / Q000209:etiology / Q000534:rehabilitation*; D006801:Humans; D007407:Interviews as Topic; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D012047:Rehabilitation Centers; D011795:Surveys and Questionnaires; D014139:Tracheostomy / Q000295:instrumentation