title: Incidence of severe dysphagia after brain surgery in pediatric traumatic brain injury: a nationwide population-based retrospective study.
abstract: OBJECTIVE
  To investigate the incidence of dysphagia and medical resource utilization in a nationwide population of pediatric patients with traumatic brain injury (TBI).
  
  
  METHODS
  Subjects' data were obtained from the Taiwan National Health Insurance Research Database.
  
  
  METHODS
  Between 2000 and 2008, 6290 children less than 18 years old who had received surgery post-TBI were included in the study.
  
  
  METHODS
  Retrospective study.
  
  
  METHODS
  Biographic data and medical utilization results.
  
  
  RESULTS
  Of all the children postsurgery after TBI, 12.3% were categorized as having severe dysphagia. The occurrence of severe dysphagia was not related to sex but was statistically and significantly related to a younger mean age. The relationship between age and dysphagia also showed an interestingly biphasic distribution, mostly in the subgroups of 1 to 3 and 16 to 18 years of age. The medical resource utilization was higher in severely dysphagia patients, but only 8.4% received intervention by a speech language pathologist.
  
  
  CONCLUSIONS
  Severe dysphagia among postsurgical pediatric patients after TBI is relatively common, and those with severe dysphagia have a greater need for medical services. However, the ratio of such patients who receive swallowing treatment is still low in Taiwan. Clinicians are prompted to pay more attention to the impairment in functional oral intake of children postsurgery after TBI.
authors.affiliation: Department of Physical Medicine and Rehabilitation, Chi Mei Medical Center, Liouying, Taiwan (Drs Huang, Tung, and Chou); Department of Physical Medicine and Rehabilitation, Chiali Chi Mei Hospital, Tainan, Taiwan (Dr Lin); Department of Medical Research, Chi Mei Medical Center, Liouying, and Department of Hospital and Health Care Administration, Chia Nan University of Pharmacy and Science, Tainan, Taiwan (Dr Ho); Department of Anesthesiology, Chi Mei Medical Center, Liouying, and Department of Recreation and Health Care Management, Chia Nan University of Pharmacy and Science, Tainan, Taiwan (Dr Chu); School of Physical Therapy, Chung Shan Medical University, and Physical Therapy Room, Chung Shan Medical University Hospital, Taichung, Taiwan (Mr Wang).
authors.forename: Chin-Tsan
authors.initials: CT
authors.lastname: Huang
authors.forename: Wen-Chih
authors.initials: WC
authors.lastname: Lin
authors.forename: Chung-Han
authors.initials: CH
authors.lastname: Ho
authors.forename: Li-Chen
authors.initials: LC
authors.lastname: Tung
authors.forename: Chin-Chen
authors.initials: CC
authors.lastname: Chu
authors.forename: Willy
authors.initials: W
authors.lastname: Chou
authors.forename: Chun-Hou
authors.initials: CH
authors.lastname: Wang
mesh_terms: D000293:Adolescent; D001930:Brain Injuries / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D003680:Deglutition Disorders / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D013624:Taiwan / Q000453:epidemiology; D055815:Young Adult