Tracking clinical improvement of swallowing disorders after stroke.
OBJECTIVE
The goal of this study was to determine recovery rates from swallowing disorders, or dysphagia, at 3 weeks and 3 months poststroke by tracking changes in nutritional management.


METHODS
Ninety-one newly diagnosed stroke patients were studied. Patients with suspected dysphagia were referred for bedside swallowing assessment, performed by a speech-language pathologist, and, where indicated, a videofluoroscopic modified barium swallow. Patients with confirmed dysphagia were initiated on either an oral dysphagia diet or enteral feeding, and they continued to receive swallowing treatment as both inpatients and out-patients. Recovery from dysphagia, based on the patient's type of diet, was assessed at days 21 and 90 poststroke.


RESULTS
On admission, 48 of 91 (53%) newly diagnosed stroke patients presented with clinical evidence of a swallowing abnormality. Forty-two percent of these patients were managed by enteral tube feedings, and 58% received a dysphagia diet. By day 21 poststoke, 13 (27%) of the initially dysphagic patients were consuming a regular diet. By day 90, 36 (75%) of these patients were consuming a regular diet; 5 patients (10%) remained dysphagic and were nutritionally managed either with a dysphagia diet or enteral feeding. A total of 7 (15%) of the 48 patients were lost to follow-up.


CONCLUSIONS
Three quarters of stroke patients initially presenting with dysphagia were consuming their prestroke diet by 3 months. Using assessment-based diet type as a proxy for the ongoing identification of dysphagia poststroke, this study found a substantial recovery rate in patients presenting with swallowing disorders.
Finestone
Hillel M
HM
Department of Physical Medicine and Rehabilitation, SCO Health Service-St. Vincent Hospital and University of Ottawa, Ontario, Canada.
Woodbury
M Gail
MG
Foley
Norine C
NC
Teasell
Robert W
RW
Greene-Finestone
Linda S
LS