Grunke Christie, Marshall Jeanne, Miles Anna, Carrigg Bronwyn, Ward Elizabeth C
School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia.
Queensland Children's Hospital, Children's Health Queensland Hospital and Health Service, Brisbane, Australia.
Dysphagia. 2024 Dec 20. doi: 10.1007/s00455-024-10795-y.
Dysphagia is common in hospitalised children. Clarity regarding its prevalence is required to direct service needs. This review reports oropharyngeal dysphagia prevalence in children admitted to acute and/or critical care, following acute illness, medical or surgical intervention. It also explores patient characteristics significantly associated with oropharyngeal dysphagia in these settings. Five electronic databases (EMBASE, CINAHL, Cochrane, PubMed, Scopus) were searched. Studies identified for inclusion involved children (0-16 years), in acute or critical care settings, where prevalence data for new-onset or worsening oropharyngeal dysphagia was reported. Peer reviewed journal articles, including systematic reviews were included. Data was extracted and synthesised using a purpose designed extraction tool. A total of 7,522 studies were screened and 67 studies met criteria. The most researched populations included congenital heart disease surgeries, posterior fossa tumour resections, stroke and post-extubation dysphagia. Populations with the highest documented dysphagia prevalence were children after posterior fossa tumour resection with a new tracheostomy, children using nasal continuous positive airway pressure, and children following ischemic stroke. Characteristics significantly associated with oropharyngeal dysphagia were younger age, lower weight, longer intubation, upper/middle airway dysfunction (e.g., vocal paresis), and presence of additional comorbidities. This review presents synthesised prevalence data for children in acute and critical care settings with new-onset or worsening oropharyngeal dysphagia. It highlights the broad nature of oropharyngeal dysphagia in hospitalised children and the need for more rigorous research into characteristics associated with increased risk to better support screening and early identification of oropharyngeal dysphagia in these settings.
吞咽困难在住院儿童中很常见。需要明确其患病率以指导服务需求。本综述报告了急性病、内科或外科干预后入住急症和/或重症监护病房的儿童的口咽吞咽困难患病率。它还探讨了在这些情况下与口咽吞咽困难显著相关的患者特征。检索了五个电子数据库（EMBASE、CINAHL、Cochrane、PubMed、Scopus）。纳入的研究涉及0至16岁、处于急性或重症监护环境中的儿童，这些研究报告了新发或加重的口咽吞咽困难的患病率数据。纳入了同行评审的期刊文章，包括系统评价。使用专门设计的提取工具提取和综合数据。共筛选了7522项研究，67项研究符合标准。研究最多的人群包括先天性心脏病手术、后颅窝肿瘤切除术、中风和拔管后吞咽困难。口咽吞咽困难患病率记录最高的人群是行新气管造口术的后颅窝肿瘤切除术后儿童、使用鼻持续气道正压通气的儿童以及缺血性中风后的儿童。与口咽吞咽困难显著相关的特征包括年龄较小、体重较低、插管时间较长、上/中气道功能障碍（如声带麻痹）以及存在其他合并症。本综述给出了急症和重症监护环境中患有新发或加重口咽吞咽困难儿童的综合患病率数据。它强调了住院儿童口咽吞咽困难的广泛性，以及需要对与风险增加相关的特征进行更严格的研究，以便更好地支持在这些情况下对口咽吞咽困难的筛查和早期识别。
