Can We Detect the Patients at Risk of Dysphagia?

Identification of dysphagia is an important task during neurorehabilitation in SCI. Light has been shed on dysfunction in high-level lesions. However, also in lower-level spinal cord lesions, dysphagia may be prevalent. The pattern in the SCI population being admitted to The Spinal Cord Injury Center of Western Denmark is changing during the last decades. Patients with non-traumatic origin of their lesions are more abundant. On average, patients are older at their first time admission. Therefore, changes in the admitted SCI population, should call for a cautious reevaluation concerning the role of dysphagia in this changed situation. It is known that dysphagia in some cases play a role as a lethal complication to SCI. Methods: During January 2016-January 2019 a total of 209 SCI in-patients underwent Eating Assessment Tool 10 (EAT10, range 0-40). Information on time-since-injury, type-of-injury, age, gender, ISNCSCI, and SCIM were gathered in our R&D units Redcap database. Results: Forteen percent (29/209) of SCI-in-patients presented with raised EAT-10 scores, with raised odds of 2.5 (CI[1.1;5.8] in persons with cervical lesions. Nine percent were seen in C0-C4, and 0% seen in C5-C8, 5 % were found in lower level injuries. The study did not detect difference between gender, age-groups or membership of non-traumatic or traumatic groups. The importance of associated injuries in traumatic SCI for dysphagia will be presented, as will the correlation between SCIM and EAT-10. Conclusion: 14 percent of SCI-in-patients presented with signs of dysphagia. The EAT-10 questionnaire was easily administered and accepted by in-patients and staff at the rehabilitation hospital. EAT-10 could support clinical decision making regarding SCI in-patients at risk of dysphagia.