865 - Prevalence of Dysphagia in the Inhalation Injury Patient

Patients with burns/inhalation injury often have a higher aspiration risk due to dysphagia. leading to serious complications. There is little data available in the research regarding dysphagia in burn patients; specifically those with inhalation injury. The goal of this study is to identify factors that may predict dysphagia and/or elevated aspiration risk in patients with inhalation injury, and to identify the need for instrumental swallow study (ISS) via Modified Barium Swallow Study or Flexible Endoscopic Evaluation of Swallow based on patient findings during clinical bedside evaluation.


Design: Retrospective review of 50 patients diagnosed with inhalation injury over the course of 4 years (2018-2022) admitted to Burn ICU at an academic level 1 trauma center. Analyzed data includes: presence of dysphonia, overt clinical signs of dysphagia, length of intubation, presence of tracheostomy, nasopharyngeal laryngoscopy (NPL) findings, completion and results of instrumental assessment, days of NPO status, and aspiration risk based on penetration-aspiration scale.

Results:

•  87% of patients with subjective dysphonia presented with clinical signs of dysphagia

• 74% of patients with clinical signs of dysphagia demonstrated dysphagia via ISS

• 69% of patients with subjective dysphonia had positive NPL findings

• 88% of patients with tracheostomy had dysphagia diagnosis on instrumental swallow study

• 58% of patients in this cohort were admitted as inhalation injury (< 5% total body surface area)

• 78% of patients who were intubated had dysphagia on ISS

There is a positive correlation between subjective dysphonia and objective diagnosis of dysphagia, meaning the presence of dysphonia may be one of the primary identifiable factors in anticipating dysphagia. Prolonged intubation and presence of tracheostomy often predicted increased aspiration risk. Instrumental swallow study is crucial in determining aspiration risk and recommending optimal diet. The collaborative role between speech-language pathologists, otolaryngologists, and burn physicians is beneficial in optimizing patient care for treatment of inhalation injury.