The time course of dysphagia following traumatic cervical spinal cord injury: a prospective cohort study
The time course of dysphagia following traumatic cervical spinal cord injury: a prospective cohort study
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DOI：
10.1038/s41393-019-0347-4
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发表时间：
2020-01-01
期刊：
影响因子：
2.2
通讯作者：
Maeda, Takeshi
中科院分区：
文献类型：
--
作者：
Hayashi, Tetsuo;Fujiwara, Yuichi;Maeda, Takeshi
Study design Prospective cohort study. Objectives To elucidate serial changes in dysphagia and elucidate the critical period for dysphagia following acute traumatic cervical spinal cord injury (CSCI). Setting Spinal Injuries Center, Fukuoka, Japan. Methods We prospectively examined individuals with acute traumatic CSCI admitted within 2 weeks after injury. Severity of dysphagia was evaluated using both the dysphagia severity scale (DSS) and functional oral intake scale (FOIS) at 2 weeks, 1 month, 2 months, and 3 months after injury. Condition of oral intake before injury was assessed by history taking. American Spinal Injury Association (ASIA) impairment scale grade and motor scores were also assessed at the same timepoints, and the correlation between dysphagia and paresis was analyzed. Results Sixty-five individuals with CSCI were assessed consecutively for 3 months after injury. Swallowing function, evaluated using both the DSS and FOIS, was significantly decreased at 2 weeks after injury, but significantly improved thereafter. Significant correlations between severity of dysphagia (DSS and FOIS scores) and motor scores were found at 2 weeks after injury (r(s) = 0.66 and 0.61; p < 0.001 and p < 0.001, respectively), indicating that individuals with lower motor scores had more severe swallowing dysfunction. Conclusions Dysphagia occurred immediately after injury, but gradually improved over time. Individuals with more severe paralysis had significantly more severe dysphagia. Special attention for dysphagia should be paid to individuals with severe paralysis in acute phase.
