Aspiration and relative risk of medical complications following stroke.
OBJECTIVE
To determine the relative risk of pneumonia, dehydration, and death associated with videofluoroscopic evidence of aspiration, silent aspiration, aspiration of 10% or greater on one or more barium test swallows, and aspiration of thick liquid or more solid consistencies in the subacute phase after stroke.


METHODS
Prospective, longitudinal cohort study.


METHODS
Inpatient stroke rehabilitation unit.


METHODS
There were 114 consecutive patients who met the following criteria: (1) stroke as defined by clinical history and neurological examination with compatible computed tomographic or magnetic resonance imaging scan; (2) age 20 to 90 years, inclusive; (3) no known history of significant oropharyngeal anomaly; and (4) videofluoroscopic evidence of dysphagia. Of 122 eligible patients, eight refused participation.


METHODS
Development of pneumonia, dehydration, and death.


RESULTS
The relative risk for developing pneumonia was 6.95 times greater (P = .027) for those patients who aspirated compared with those who did not, 5.57 times greater (P = .012) for those who aspirated silently compared with those who coughed when aspirating or who did not aspirate, and 8.36 times greater (P = .002) for those who aspirated 10% or greater on one or more barium test swallows compared with those who aspirated less than 10% or did not aspirate.


CONCLUSIONS
Aspiration, silent aspiration, and aspiration of 10% or greater on one or more barium test swallows during videofluoroscopic evaluation are associated with an increased risk of pneumonia, but not dehydration or death, during the subacute phase after stroke.
Holas
M A
MA
Cornell University Medical College, Burke Rehabilitation Hospital, White Plains, NY.
DePippo
K L
KL
Reding
M J
MJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002561:Cerebrovascular Disorders / Q000150:complications*; D003643:Death; D003680:Deglutition Disorders / Q000209:etiology; D003681:Dehydration / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011015:Pneumonia, Aspiration / Q000209:etiology*