Compare complications during hospitalization between patients with and without dysphagia following acute stroke.
Sandra Badial1, Ildefonso Rodriguez-Leyva1, Juan Francisco Hernandez-Sierra1
1Facultad de Medicina, Universidad Autonoma de San Luis Potosi
Objective:

To compare the frequency of complications in patients with the acute stroke with and without dysphagia during hospitalization.

Background:

Stroke is a clinical syndrome that develops suddenly with signs of brain function alteration for more than 24 hours; affecting approximately 13.7 million people per year. It is the second leading cause of death.

Dysphagia (difficulty in swallowing) is a common complication (37-78%), generating associated complications such as malnutrition, dehydration, reduced quality of life, prolonged hospital stay (PHD), aspiration pneumonia and death.

Dysphagia can be detected using The Gugging Swallowing Screen (GUSS) test which has a sensitivity of 100%, specificity of 50% and negative predictive value (NPV) of 100% for predicting aspiration risk.

Design/Methods:

A prospective cohort study. The sample size was determined for a logistic regression model, which included 2 degrees of freedom, obtaining a sample size of 38 patients.

Results:

A total of 38 patients were included, whose mean age was 68.78. Ischemic etiology was predominated (86.84%), being more frequent in the left middle cerebral artery with 16 patients (48.48%).

The average NIHSS scale score for patients with dysphagia was 13.2 points vs 8.35 points for patients without dysphagia.

A higher frequency of complications was observed in the dysphagia group at 94.44% vs 35% in the no dysphagia group. The most frequent complications for dysphagia group were pneumonia in 88.88%, PHD (> 5 days) in 83.33% and mortality in 27.77%.

The results show the relationship between dysphagia and pneumonia (p= <0.001), mortality (p=0.011) and PHD (p=<0.001).

Conclusions:

We can conclude that dysphagia after acute stroke is a marker of severity since secondary complications have an impact on pneumonia, PHD and mortality. It is essential make an early screening for dysphagia in all patients with stroke, paying particular attention to those with an NIHSS score >13 points.

10.1212/WNL.0000000000203161