• Annette Kjaersgaard, Lars Hedemann Nielsen, and Bengt H Sjölund.
• 1The Institute of Public Health, University of Southern Denmark, Odense, Denmark.
• Clin Rehabil. 2014 Mar 1;28(3):243-53.

ObjectiveTo examine whether patients assessed for initiation of oral intake only by Facial-Oral Tract Therapy had a greater risk of developing aspiration pneumonia during neurorehabilitation than patients assessed by Fibreoptic Endoscopic Evaluation of Swallowing.DesignRandomized controlled trial.SettingSpecialized, national neurorehabilitation centre.SubjectsAdult patients with acquired brain injury. Six hundred and seventy-nine patients were assessed for eligibility and 138 were randomly allocated between June 2009 and April 2011.InterventionsAssessment by Facial-Oral Tract Therapy (control group) or Fibreoptic Endoscopic Evaluation of Swallowing (intervention group).Main MeasurePrimary outcome was the number of aspiration pneumonias that developed after initiation of oral intake.ResultsOne hundred and nineteen patients were included in the analysis of the primary outcome (62 controls/57 interventions). Sixteen patients were clinically diagnosed with pneumonia (4 controls/12 interventions). Nine patients had to be excluded: 6 patients got pneumonia before initiating oral intake; 3 patients with the clinical diagnosis of pneumonia did not show radiological signs. Seven patients were left for analysis, 4 of whom developed aspiration pneumonia within 10 days after initiating oral intake (1 control/3 interventions).ConclusionIn the presence of a structured clinical assessment with the Facial-Oral Tract Therapy approach, it is unnecessary to undertake an instrumental investigation of swallowing before initiation of oral intake.

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