Anna F Rumbach1, Elizabeth C Ward2, Sarah Heaton3, Lynell V Bassett3, Anne Webster4, Michael J Muller5. 1. School of Health and Rehabilitation Sciences, Division of Speech Pathology, The University of Queensland, Brisbane, Australia. Electronic address: a.rumbach@uq.edu.au. 2. 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. 3. Speech Pathology Department, Royal Brisbane & Women's Hospital, Queensland, Australia. 4. Professor Stuart Pegg Adult Burns Centre, Royal Brisbane & Women's Hospital, Brisbane, Australia. 5. 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.
Abstract
PURPOSE: 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. METHOD(S): 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. RESULT(S): 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%). CONCLUSION: 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.
PURPOSE: 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. METHOD(S): 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. RESULT(S): 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%). CONCLUSION: 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.