Fiberoptic endoscopic evaluation of swallowing in patients with cervical spinal cord injury: a retrospective study focused on oral intake at discharge

Abstract

Abstract Study Design: single-center retrospective cohort study. Objectives Dysphagia is a common secondary complication of cervical spinal-cord injury (CSCI); however, its long-term prognosis remains unknown. We aimed to clarify the characteristics of CSCI-related dysphagia using fiberoptic endoscopic evaluation of swallowing (FEES), and to identify factors associated with acquisition of full oral intake during hospitalization. Setting: An academic medical center in Japan. Methods Data of patients with CSCI-related dysphagia were retrospectively collected and compared between patients who achieved full oral intake during hospitalization (oral-intake group) and those mainly relying on feeding tubes for nutrition (parenteral-nutrition group). Results A total of 100 participants met the inclusion criteria. The oral-intake and parenteral-nutrition groups included 35 and 65 participants, respectively. Univariate analysis revealed significant differences in age, length of hospital stay, and Barthel Index (BI) gain between the two groups. FEES revealed that only vallecular residues were significantly greater in the parenteral-nutrition group, with an effect size of 0.24, which was higher than that of other FEES parameters. Conclusions In this study, the oral-intake group tended to have younger age, longer duration of hospital stay, and higher BI gain. The detection of vallecular residues on FEES could be a prognostic factor for parenteral nutrition at discharge. Sponsorship: No commercial companies sponsored this study.