Objectives: To investigate the incidence of dysphagia and medical resource utilization in a nationwide population of pediatric patients with traumatic brain injury (TBI). Setting: Subjects' data were obtained from the Taiwan National Health Insurance Research Database. Participants: Between 2000 and 2008, 6290 children less than 18 years old who had received surgery post-TBI were included in the study. Design: Retrospective study. Main Outcome Measure: Biographic data and medical utilization results. Results: Of all the children postsurgery after TBI, 12.3% were categorized as having severe dysphagia. The occurrence of severe dysphagia was not related to sex but was statistically and significantly related to a younger mean age. The relationship between age and dysphagia also showed an interestingly biphasic distribution, mostly in the subgroups of 1 to 3 and 16 to 18 years of age. The medical resource utilization was higher in severely dysphagia patients, but only 8.4% received intervention by a speech language pathologist. Conclusions: Severe dysphagia among postsurgical pediatric patients after TBI is relatively common, and those with severe dysphagia have a greater need for medical services. However, the ratio of such patients who receive swallowing treatment is still low in Taiwan. Clinicians are prompted to pay more attention to the impairment in functional oral intake of children postsurgery after TBI.
Journal of Head Trauma Rehabilitation, v.29 n.6, pp.E31-E36