# Prognostic Factors of Dysphagia and Recovery Following Pediatric Acquired Brain Injury

## TL;DR

Most children with brain injuries experience swallowing difficulties, but many recover with treatment, especially if they are more alert when admitted.

## Contribution

Identifies key factors predicting dysphagia and recovery in children with acquired brain injury.

## Key findings

- 61% of children with ABI had dysphagia at admission.
- 78.68% of children with dysphagia recovered with speech-language pathology treatment.
- Reduced consciousness and cranial nerve impairment were strong predictors of dysphagia.

## Abstract

What are the main findings?
61% of children with acquired brain injury (ABI) presented with dysphagia.Recovery rate was 78% with assigned treatment.Reduced consciousness state, cranial nerve involvement, voice disorders, and etiology of CNS tumors were associated with dysphagia post ABI.Recovery of dysphagia was associated with conscious state at admission and severity of dysphagia

61% of children with acquired brain injury (ABI) presented with dysphagia.

Recovery rate was 78% with assigned treatment.

Reduced consciousness state, cranial nerve involvement, voice disorders, and etiology of CNS tumors were associated with dysphagia post ABI.

Recovery of dysphagia was associated with conscious state at admission and severity of dysphagia

What are the implications of the main findings?
All children with ABI should be evaluated for dysphagia at admission to rehabilitation.Recovery rate of dysphagia in children with acquired brain injury with assigned treatment is high.

All children with ABI should be evaluated for dysphagia at admission to rehabilitation.

Recovery rate of dysphagia in children with acquired brain injury with assigned treatment is high.

Objectives: Dysphagia is a major complication of acquired brain injury (ABI) in children; however, its trajectory and prognostic indicators remain insufficiently characterized. This study aimed to identify predictors of dysphagia and its recovery following pediatric ABI. Methods: This retrospective study included all children admitted with ABI to tertiary pediatric rehabilitation center between 2014 and 2017. Data were collected from electronic medical records. Results: One hundred children aged 2:00–17:11 years were included; 61% had dysphagia at admission. Participants with dysphagia received speech–language pathology (SLP) treatment, with a recovery rate of 78.68%. Treatment duration was significantly shorter among children who recovered (36 days) compared with those who did not (136 days; p < 0.001). Dysphagia at admission was associated with mechanical ventilation, duration of unconsciousness, duration of acute hospitalization, CNS tumor etiology, cranial nerve impairment (V, IX, X, XII), voice and speech impairments, and cognitive and behavioral impairments. Logistic regression showed that reduced consciousness, cranial nerve impairment, voice disorders, and CNS tumors explained 70.6% of dysphagia likelihood. Non-recovery was associated with unconsciousness, enteral feeding, hypoglossal injury, and dysphagia severity at admission. Level of consciousness at admission explained 33.7% of recovery likelihood. Conclusions: Dysphagia was highly prevalent among children with ABI. Recovery rates following SLP treatment were high and were associated with level of consciousness at admission to rehabilitation.