Complications and outcome after acute stroke : Does dysphagia matter ?

The published data on the relationship between dysphagia and both outcome and complications after acute stroke have been inconclusive. We examined the relationship between these, using bedside assessment and videofluoroscopic examination. We prospectively studied 121 consecutive patients admitted wi...

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Bibliographic Details
Published in:Stroke (1970) 1996-07, Vol.27 (7), p.1200-1204
Main Authors: SMITHARD, D. G, O'NEILL, P. A, MORRIS, J, WYATT, R, ENGLAND, R, MARTIN, D. F
Format: Article
Language:English
Subjects:
Acute Disease
Adult
Aged
Aged, 80 and over
Biological and medical sciences
Cerebrovascular Disorders - complications
Cerebrovascular Disorders - therapy
Cineradiography
Deglutition - physiology
Deglutition Disorders - etiology
Deglutition Disorders - physiopathology
Female
Fluoroscopy
Follow-Up Studies
Forecasting
Foreign Bodies - etiology
Humans
Institutionalization
Length of Stay
Lung
Male
Medical sciences
Middle Aged
Neurology
Nutritional Status
Patient Discharge
Patients' Rooms
Prospective Studies
Respiratory Tract Infections - etiology
Single-Blind Method
Treatment Outcome
Vascular diseases and vascular malformations of the nervous system
Water-Electrolyte Balance
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Summary:The published data on the relationship between dysphagia and both outcome and complications after acute stroke have been inconclusive. We examined the relationship between these, using bedside assessment and videofluoroscopic examination. We prospectively studied 121 consecutive patients admitted with acute stroke. A standardized bedside assessment was performed by a physician. We performed videofluoroscopy blinded to this assessment within 3 days of stroke onset and within a median time of 24 hours of the bedside evaluations. The presence of aspiration was recorded. Mortality, functional outcome, lengthy of stay, place of discharge, occurrence of chest infection, nutritional status, and hydration were the main outcome measures. Patients with an abnormal swallow (dysphagia) on bedside assessment had a higher risk of chest infection (P=.05) and a poor nutritional state (P=.001). The presence of dysphagia was associated with an increased risk of death (P=.001), disability (P=.02), length of hospital stay (P
ISSN:0039-2499
1524-4628
DOI:10.1161/01.STR.27.7.1200