Dysphagia in the burn patient: Experience in a National Burn Reference Centre

Abstract

IntroductionMajor burn patients are exposed to different invasive procedures for wound management or medical stabilization. Dysphagia is a frequent adverse effect of burns in the presence of invasive airway procedures and facial wounds. ObjectiveTo estimate the prevalence of dysphagia, to determine the degree of severity, and to report clinical characteristics that could contribute to the appearance of dysphagia in patients admitted to a National Burn Reference Centre. MethodsAn observational cross-sectional study was conducted in a burn reference centre over a 6-month period. All patients admitted to the burn service of a National Reference Centre were included. A clinical bedside swallowing assessment was performed in patients referred to a Speech-Language Pathologist (SLP). The presence or absence of dysphagia was evaluated, and the degree of severity was measured according to the Dysphagia Outcome and Severity Scale (DOSS). ResultsFifty-four participants were recruited. The prevalence of dysphagia over a 6-month period was 27.78% (n=15) of the total burn patients admitted to the Burn Unit. The severity of dysphagia varied from mild (26.7%), mild-moderate (33.3%), moderate (20%), moderate-severe (13.3%), to severe (6.7%). All dysphagia patients had orotracheal intubation history with an average length of 18 days, as opposed to the non-dysphagia group, of which 75% of the participants had orotracheal intubation history for an average of 8.5 days. Statistically non-significant associations were found between dysphagia and demographic aspects or clinical characteristics (p>0.05). Conclusion27.78% of burn patients presented dysphagia, with differences in the degree of severity. Presence and duration of orotracheal intubation stands out as a condition of interest. The SLP inclusion in the burn team is presented as a valuable input in order to minimize risks associated with swallowing impairment.