Dysphagia in acute ischaemic stroke: severity, recovery and relationship to stroke subtype.
Dysphagia in stroke is linked with increased risk of pneumonia, increased length of stay and poorer outcomes. This study followed a cohort of 88 acute ischaemic stroke patients admitted to hospitals in Perth, Western Australia, over 30 days. There were 8/88 deaths (9%). Infections were treated in 25/80 survivors (31%). Presence and severity of dysphagia were measured at 2 and 7 days post-stroke. Respiratory tract infections occurred at significantly higher rates for dysphagics (p<0.05). At 2 days post-stroke, the odds ratio (OR) of chest infection for dysphagics was 1.45 (95% CI=1.07-1.98). Survivors who were "nil by mouth" 2 days post-stroke were significantly more likely to develop pneumonia (p=0.01). At 7 days post-stroke, dysphagics were again more likely to develop pneumonia (p=0.014) with OR=1.77 (95% CI=1.26-2.49). The total anterior circulation infarcts demonstrated more severe and prolonged dysphagia than other stroke subtypes.
Langdon
P Claire
PC
School of Public Health, Curtin University of Technology, Perth, WA, Australia. Claire.Langdon@health.wa.gov.au
Lee
Andy H
AH
Binns
Colin W
CW
D000368:Aged; D015331:Cohort Studies; D003680:Deglutition Disorders / Q000209:etiology* / Q000401:mortality / Q000473:pathology / Q000503:physiopathology; D003710:Demography; D005260:Female; D006801:Humans; D008297:Male; D016017:Odds Ratio; D020127:Recovery of Function; D012307:Risk Factors; D012720:Severity of Illness Index; D020521:Stroke / Q000145:classification* / Q000150:complications* / Q000453:epidemiology; D013997:Time Factors; D014904:Western Australia / Q000453:epidemiology