@entity1282 in severe XXXX : risk factors affecting return to oral intake.

@entity1545 @entity1 @entity73 @entity772 @entity4939 @entity1282 @entity130 @entity1173
OBJECTIVE: To determine the incidence and @entity1282 that accompany severe @entity1545 and to identify factors that affect oral intake. DESIGN: Inception cohort study. SETTING: Level I @entity130 center. @entity1 : Consecutively admitted @entity1 with severe @entity1545 who achieved cognitive levels during admission to assess swallowing and who did not sustain injuries preventing swallowing assessment (n = 54). MAIN OUTCOME MEASURES: Type of swallowing abnormalities and presence of @entity1173 evident on videofluoroscopic swallow studies (VFSS), days to initiation and achievement of oral feeding, ventilation days, presence of a tracheostomy, and cognitive levels at initiation and achievement of oral feeding. RESULTS: Sixty-one percent of subjects exhibited @entity4939 . Loss of bolus control and reduced lingual control occurred most commonly. Aspiration rate was 41%. Normal swallowers achieved oral feeding in 19 days versus 57 days for abnormal swallowers. Rancho Los Amigos (RLA) Level IV was needed for initiation of oral feeding; Level VI was needed for total oral feeding. Risk factors for @entity4939 included: lower admission Glasgow @entity772 Scale (GCS) and RLA scores, presence of a tracheostomy, and ventilation time longer than 2 weeks. Risk factors for @entity1173 were lower admission GCS and RLA scores. CONCLUSIONS: @entity1282 and @entity73 are frequently present in @entity1 with severe @entity1545 and significantly affect oral intake of food. @entity1 who swallow abnormally take significantly longer to start eating and to achieve total oral feeding, and they require nonoral supplementation three to four times longer than those who swallow normally.
