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Dysphagia in acute tetraplegics: A retrospective study
Spinal Cord, 08/14/09

Seidl RO et al. – Results show no single trigger for a swallowing disorder in acute tetraplegia. A combination of multiple factors (level of tetraplegia, severity of paralysis, tracheotomy, accompanying injuries and accompanying illnesses) restricts swallowing and compensation of changes, to the extent that a swallowing disorder becomes apparent.

• Retrospective study of factors influencing the incidence and clinical data for swallowing disorder in hospitalized pts with acute tetraplegia
• Setting: Level I trauma center, Berlin, Germany
• Clinical and endoscopic assessment of pt swallowing ability
• Correlation of results for swallowing ability with clinical data

• Total of 175 pts: 144 male (82.29%); 31 female (17.71%); 4.6:1
• Peak age groups (43.45, +/-.98, 14–89 yrs): 20–30 yrs and >60 yrs
• C4–C6 most commonly affected
• Tetraplegia trauma-related in 147 (84%) pts
• Swallowing disorder on first feeding for 28 pts (16.0%)
• Tracheotomy for 23 dysphagia pts (82.14%)
• Tetraplegia level, tracheotomy, and ventilation duration all statistically significant factors in development of swallowing disorder
• Age, surgical approach, tetraplegia level, paralysis severity, and need for tracheotomy predictive of dysphagia in 73.14% pts
• Mortality in 5 dysphagia pts due to causes other than dysphagia
• Discharge with feeding tube for 10 pts

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