title: Validation of predictive factors of dysphagia risk following thermal burns: a prospective cohort study.
abstract: OBJECTIVE
  The objective of this study was to prospectively evaluate the validity and reliability of a risk factor model developed for use in predicting dysphagia risk within the first 24 h after injury/hospitalisation in patients with thermal burns.
  
  
  METHODS
  Three hundred and fifty six patients with thermal burns, with or without inhalation injury, who were consecutively admitted to and received management at a quaternary state-wide burn center over a 12 month period, were included. Patients were reviewed for dysphagia risk by nursing staff using an established set of predictive factors. If risk factors for dysphagia were present, referral to speech-language pathology was initiated to investigate swallow function.
  
  
  RESULTS
  Of the 356 admissions, 83 patients were identified as meeting one or more risk criteria for dysphagia after burn. Of these, 24.9% (n = 30; 8.42% of the total cohort) presented with dysphagia. Using these criteria, sensitivity and specificity for detection of dysphagia risk were high (100% and 83.74%, respectively). The criteria over identify patients who may be at risk of dysphagia and who require dysphagia assessment (positive predictive value = 36.14%). However, as a set of predictors of dysphagia risk when thermal burn is the only complaint, a negative result reassures that a patient does not have dysphagia (negative predictive value = 100%).
  
  
  CONCLUSIONS
  Overall, the risk factor model provided a valid measure for predicting dysphagia risk. Incorporating these criteria into a dysphagia screening assessment can ensure an evidence-based pathway for early detection and timely referral to speech-language pathology for patients at risk of dysphagia after thermal burns.
authors.affiliation: School of Health and Rehabilitation Sciences, Division of Speech Pathology, The University of Queensland, Brisbane, Australia. Electronic address: a.rumbach@uq.edu.au.
authors.forename: Anna F
authors.initials: AF
authors.lastname: Rumbach
authors.affiliation: School of Health and Rehabilitation Sciences, Division of Speech Pathology, The University of Queensland, Brisbane, Australia; Centre for Functioning and Health Research, Queensland Health , Brisbane, Australia.
authors.forename: Elizabeth C
authors.initials: EC
authors.lastname: Ward
authors.affiliation: Speech Pathology Department, Royal Brisbane & Women's Hospital, Queensland, Australia.
authors.forename: Sarah
authors.initials: S
authors.lastname: Heaton
authors.affiliation: Speech Pathology Department, Royal Brisbane & Women's Hospital, Queensland, Australia.
authors.forename: Lynell V
authors.initials: LV
authors.lastname: Bassett
authors.affiliation: Professor Stuart Pegg Adult Burns Centre, Royal Brisbane & Women's Hospital, Brisbane, Australia.
authors.forename: Anne
authors.initials: A
authors.lastname: Webster
authors.affiliation: Professor Stuart Pegg Adult Burns Centre, Royal Brisbane & Women's Hospital, Brisbane, Australia; Burns, Trauma & Critical Care Research Centre, The University of Queensland, Brisbane, Australia.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Muller
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002056:Burns / Q000150:complications*; D015331:Cohort Studies; D006259:Craniocerebral Trauma / Q000150:complications*; D003680:Deglutition Disorders / Q000175:diagnosis* / Q000209:etiology; D005260:Female; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D019838:Neck Injuries / Q000150:complications*; D011446:Prospective Studies; D015203:Reproducibility of Results; D012121:Respiration, Artificial / Q000706:statistics & numerical data; D018570:Risk Assessment; D012307:Risk Factors; D012680:Sensitivity and Specificity; D015208:Smoke Inhalation Injury / Q000150:complications*; D055815:Young Adult
keywords: Burns; Dysphagia; Early intervention; Referral criteria; Risk; Screening