• Burns · Nov 2024

    Swallowing impairment in older persons following burn injury: Validation of incidence and predictive factors for dysphagia.

    • Nicola A Clayton, Caroline M Nicholls, Cheryl Brownlow, Justine O'Hara, Andrea C Issler-Fisher, Oliver M Fisher, and Peter K Maitz.
    • Speech Pathology Department, Concord Repatriation General Hospital, NSW, Australia; Burns Unit, Concord Repatriation General Hospital, NSW 2139, Australia; School of Health & Rehabilitation Sciences, University of Queensland, QLD, Australia; Faculty of Medical and Health Sciences, University of Sydney, NSW, Australia. Electronic address: nicola.clayton@health.nsw.gov.au.
    • Burns. 2024 Nov 1; 50 (8): 208420902084-2090.

    BackgroundEarly retrospective data identify that dysphagia is common in older persons with burn injury, suggesting a rate of 47 %, and that it is associated with medical, burn, and nutritional outcomes.AimsTo prospectively (1) explore the incidence, (2) describe associations, and (3) evaluate risk factors for dysphagia in patients ≥ 75 years old hospitalised with burn injury.MethodsAll patients > 75 years old admitted to Concord-Repatriation-General-Hospital with burn injury over 4 years (2019-2023) were assessed for dysphagia on presentation and were continually monitored throughout their admission. Burn injury, demographic, and nutritional data were prospectively captured and analysed for association with dysphagia.ResultsSixty-two patients (33 male) aged 75-95 years (median=83 years) were recruited. Dysphagia was identified in 50 %. Dysphagia was associated with burn size (p = 0.002), pre-existing cognitive impairment (p = 0.000), hospital length of stay (p = 0.001), in-hospital complications (p = 0.000), feeding dependence (p = 0.002), nutritional status (p = 0.013) and enteral feeding duration (p = 0.030). Cognitive impairment was the most sensitive predictor for dysphagia at 100 % (specificity=29 %, NPV=100 %, PPV=59 %). Development of secondary comorbidities was less sensitive at 52 % (NPV 65 %), but was associated with high specificity (90 %) and PPV (84 %).ConclusionsOne in every two patients ≥ 75 years admitted with burn injury will demonstrate dysphagia during their hospital admission. Those with pre-existing cognitive impairment are most at risk.Crown Copyright © 2024. Published by Elsevier Ltd. All rights reserved.

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