title: Dysphagia and associated respiratory considerations in cervical spinal cord injury.
abstract: BACKGROUND
  Dysphagia is a relatively common secondary complication that occurs after acute cervical spinal cord injury (SCI). The detrimental consequences of dysphagia in SCI include transient hypoxemia, chemical pneumonitis, atelectasis, bronchospasm, and pneumonia. The expedient diagnosis of dysphagia is imperative to reduce the risk of the development of life-threatening complications.
  
  
  OBJECTIVE
  The objective of this study was to identify risk factors for dysphagia after SCI and associated respiratory considerations in acute cervical SCI.
  
  
  METHODS
  Bedside swallow evaluation (BSE) was conducted in 68 individuals with acute cervical SCI who were admitted to an SCI specialty unit. Videofluroscopy swallow study was conducted within 72 hours of BSE when possible.
  
  
  RESULTS
  This prospective study found dysphagia in 30.9% (21 out of 68) of individuals with acute cervical SCI. Tracheostomy (P = .028), ventilator use (P = .012), and nasogastric tube (P = .049) were found to be significant associated factors for dysphagia. Furthermore, individuals with dysphagia had statistically higher occurrences of pneumonia when compared with persons without dysphagia (P < .001). There was also a trend for individuals with dysphagia to have longer length of stay (P = .087).
  
  
  CONCLUSIONS
  The role of respiratory care practitioners in the care of individuals with SCI who have dysphagia needs to be recognized. Aggressive respiratory care enables individuals with potential dysphagia to be evaluated by a speech pathologist in a timely manner. Early evaluation and intervention for dysphagia could decrease morbidity and improve overall clinical outcomes.
authors: Department of Physical Medicine and Rehabilitation Santa Clara Valley Medical Center, San Jose , California.
authors: Edward
authors: E
authors: Chaw
authors: Kazuko
authors: K
authors: Shem
authors: Kathleen
authors: K
authors: Castillo
authors: Sandra Lynn
authors: SL
authors: Wong
authors: James
authors: J
authors: Chang
keywords: dysphagia; respiratory complications; spinal cord injuries; tetraplegia