Department of Special Education and Communication Disorders

 

ORCID IDs

Dietsch 0000-0003-4554-5365

Document Type

Article

Date of this Version

2-2020

Citation

Journal of Trauma and Acute Care Surgery (February 2020) 89(2, Supplement 2): S192–S199

doi: 10.1097/TA.0000000000002623

Comments

Copyright © 2020, Wolters Kluwer Health. Used by permission

Abstract

Background: Traumatic injuries, such as those from combat-related activities, can lead to complicated clinical presentations that may include dysphagia.

Methods: This retrospective observational database study captured dysphagia-related information for 215 United States military service members admitted to the first stateside military treatment facility after sustaining combat-related or combat-like traumatic injuries. A multidimensional relational database was developed to document the nature, course, and management for dysphagia in this unique population and to explore variables predictive of swallowing recovery using Bayesian statistical modeling and inferential statistical methods.

Results: Bayesian statistical modeling revealed the importance of maxillofacial fractures and soft tissue loss as primary predictors of poor swallowing outcomes. The presence of traumatic brain injury (TBI), though common, did not further complicate dysphagia outcomes. A more detailed examination and rating of videofluoroscopic swallow studies from a subset of 161 participants supported greater impairment for participants with maxillofacial trauma and no apparent relationship between having sustained a TBI and swallow functioning.

Conclusion: These analyses revealed that maxillofacial trauma is a stronger indicator than TBI of dysphagia severity and slower or incomplete recovery following combat-related injuries.

Level of evidence: Therapeutic/Care Management study, level IV.

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