1. Dysphagia following acute stroke and its effect on short-term outcome
- Author
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SA Abubakar and Bello Yusuf Jamoh
- Subjects
Adult ,Male ,Pediatrics ,medicine.medical_specialty ,Nigeria ,Aspiration pneumonia ,03 medical and health sciences ,0302 clinical medicine ,Swallowing ,Modified Rankin Scale ,Predictive Value of Tests ,otorhinolaryngologic diseases ,medicine ,Humans ,cardiovascular diseases ,030212 general & internal medicine ,Prospective Studies ,Risk factor ,Prospective cohort study ,Stroke ,Aged ,business.industry ,Stroke Rehabilitation ,General Medicine ,Recovery of Function ,Middle Aged ,medicine.disease ,Dysphagia ,Cohort ,Female ,medicine.symptom ,business ,Deglutition Disorders ,030217 neurology & neurosurgery - Abstract
Background: Dysphagia is assciated with numerous medical conditions including stroke, and there are wide variations in reported frequency of dysphagia in stroke survivors in the literature. Dysphagia has been shown to be an important risk factor for aspiration pneumonia and has profound impact on survivors. Aims: This study aims to determine the frequency of dysphagia in stroke survivors and its effects on short-term outcome. Methods: Consecutive patients hospitalised for first-ever acute stroke at Ahmadu Bello University Teaching Hospital Zaria, Nigeria, were prospectively enrolled from April 2015 to January 2017. Stroke severity was assessed using the National Institute of Health Stroke Scale (NIHSS). Water swallowing test was used to screen patients for the presence of dysphagia. This was followed by swallowing provocative test which was aimed at evaluating swallowing reflexes. All the patients were then followed up till day 30. Outcome measures applied were 30-day mortality and functional impairment on the Modified Rankin Scale. Results: Ninety-four patients (53 males and 41 females) with acute stroke were studied. Mean age of patients was 55.51 ± 15.7 years and 32 (34.4%) patients had dysphagia at presentation. Mean NIHSS score of patients with dysphagia was significantly higher than those without dysphagia. Aspiration pneumonia occurred more significantly in those with dysphagia. In multivariate logistic regression, only aspiration pneumonia was independently associated with 30-day mortality. Conclusion: The prevalence of dysphagia in this cohort of stroke patients was 34.4%, and the major independent determinant of 30-day mortality was development of aspiration pneumonia.
- Published
- 2017