Acquisition of oral intake in severely dysphagic patients with acute stroke: A single-center, observational study involving a database of 4972 consecutive stroke patients

Nakajima, Makoto; Inatomi, Yuichiro; Yonehara, Toshiro; Hashimoto, Yoichiro; Hirano, Teruyuki

doi:10.1016/j.jns.2012.08.006

Cited by 14 publications

(13 citation statements)

References 30 publications

(57 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In the literature, similar to the recent study, the reports in which NIHSS and MRS were used in stroke patients with dysphagia, the rises of dysphagia levels (severity) were correlated to the increases of stroke severity and disability [9,[25][26][27]. In the present study, due to A-0 and A-C intervals are longer in all patients comparing to the control group, a comparison between the stroke severity and disability level could not be done.…”

Section: Discussionsupporting

confidence: 68%

The Role of Electrophysiologic Evaluation in Dysphagia Diagnosis in Acute Stroke Patients

Umay¹

2014

Int J Phys Med Rehabil

View full text Add to dashboard Cite

Background and Purpose: It was aimed at investigating the efficiency of electrophysiological evaluation procedure by compared to healthy controls in acute period stroke patients in this study. As a secondary aim, it was evaluated that whether the patient groups defined as "dysphagic" and "with normal swallowing" were different from each other or not, in respect to the stroke severity and disability.

show abstract

Section: Discussionsupporting

confidence: 68%

The Role of Electrophysiologic Evaluation in Dysphagia Diagnosis in Acute Stroke Patients

Umay¹

2014

Int J Phys Med Rehabil

View full text Add to dashboard Cite

show abstract

“…13 More recent studies show an higher prevalence of cardioembolic stroke, which represented 49% of strokes in Sweden and 56% of inpatients in Japan. 14 We found no change in patients presenting with AF over time. Approximately half of all patients with AF and less than one third of patients with cardioembolic stroke/TIA and AF were anticoagulated at the time of referral.…”

Section: Bogiatzi Et Al Secular Trends In Stroke Subtypes 3211mentioning

confidence: 54%

Secular Trends in Ischemic Stroke Subtypes and Stroke Risk Factors

Bogiatzi

Hackam

McLeod

et al. 2014

Stroke

123

View full text Add to dashboard Cite

Ischemic strokes account for ≈87% of all types of strokes; the distribution of ischemic stroke subtypes varies in different parts of the world.1 In Asia and South America, small vessel disease is the most prominent ischemic stroke subtype, whereas in Europe and the United States there is regional and ethnic variation in the distribution of stroke subtypes and their risk factors.2 Correctly identifying the cause of stroke is important for selection of the appropriate therapy to best reduce the risk of recurrence. 3 This may be particularly important in patients with minor or moderate stroke/transient ischemic attack (TIA), because they are less disabled, so will have more to lose from a recurrent stroke. With changing patterns of practice, in particular, increasing use of statins in the past decade, the distribution of risk factors and stroke subtypes in this population is expected to change over time. Changes in stroke subtypes resulting from these changes in practice can be expected to lead to changes in how physicians view the likelihood of different causes of stroke among their patients and plan strategies for investigation of their patients.The motivation for this study was the clinical suspicion, on the part of 2 senior stroke neurologists at our center, that cardioembolic strokes seemed to be increasing as a proportion of new patients referred to our local urgent TIA clinic. Our primary objective was to determine secular trends in ischemic stroke subtypes. We hypothesized that with more intensive management of atherosclerotic risk factors, there will have been a decrease in atherosclerotic risk factors and a decrease in large artery atherosclerosis and small vessel disease, and, in consequence, a proportional increase in cardioembolic stroke/TIA. Methods Study Setting and TimelineThis was a retrospective cohort study of patients diagnosed with minor or moderate stroke/TIA at the urgent TIA Clinic at University Hospital, a designated regional stroke hospital in London, Ontario. Based on Census reports from Statistics Canada, 599 538 residents were living in the referral area in 2006, and 619 881 residents were recorded in 2011. According to the 2011 census, 82% of the population of London are white, 2.7% Latin American, 2.6% Arab, 2.4% black, 2.2% South Asian, 2.0% Chinese, 1.9% Aboriginal, 1% Southeast Asian, 0.8% West Asian, 0.8% Korean, 0.6% Filipino, and 0.7% belong to other groups. In the surrounding farming area a higher Background and Purpose-Early diagnosis and treatment of a stroke improves patient outcomes, and knowledge of the cause of the initial event is crucial to identification of the appropriate therapy to maximally reduce risk of recurrence. Assumptions based on historical frequency of ischemic subtypes may need revision if stroke subtypes are changing as a result of recent changes in therapy, such as increased use of statins. Methods-We analyzed secular trends in stroke risk factors and ischemic stroke subtypes among patients with transient ischemic attack or minor or moderate stroke refer...

show abstract

“…Age [1718], black race [18], initial GCS score [18], ICH volume [1819] and Functional Independence Measure (FIM) scores on admission [17] were known to be independent predictors for long-term dysphagia in patients with hemorrhagic stroke. In comparison, the NIHSS score [2021], age [202122], left-sided lesion [23], history of diabetes [22], and baseline functional independence [21] were risk factors for dysphagia in ischemic stroke. The GCS is the one of the important prognostic factors for functional recovery in aSAH [24]: the poor neurological status at the onset as captured by the GCS and NIHSS affected the prognosis of dysphagia in both ischemic and hemorrhagic strokes as a result.…”

Section: Discussionmentioning

confidence: 99%

Characteristics of Patients With Aneurysmal Subarachnoid Hemorrhage and Risk Factors Related to Dysphagia

et al. 2016

View full text Add to dashboard Cite

ObjectiveTo investigate the characteristics and risk factors of dysphagia with the Videofluoroscopic Dysphagia Scale (VDS) using a videofluoroscopic swallowing study (VFSS) in patients with ruptured aneurysmal subarachnoid hemorrhage (aSAH).MethodsData of 64 patients presenting with first-ever ruptured aSAH were analyzed. Characteristics of dysphagia were evaluated using VFSS and all subjects were divided into a high (>47) and low risk group (≤47) by the VDS score. Clinical and functional parameters were assessed by medical records including demographics, hypertension and diabetes mellitus (DM), the Glasgow Coma Scale (GCS), the Hunt and Hess scale, endotracheal intubation, acute management modalities, as well as Korean version of the Mini-Mental Status Examination (K-MMSE) and Korean version of Modified Barthel Index (K-MBI). Radiologic factors identified the amount of hemorrhage, ventricular rupture, and aneurysmal location.ResultsAbout a half of the subjects showed oral phase abnormalities and the oral transit time was delayed in 46.8% of the patients. The pharyngeal transit time was also prolonged in 39.0% of the subjects and the proportion of penetration and aspiration observed was 46.8%. The parameters-GCS score (p=0.048), hemorrhagic volume (p=0.028), presence of intraventricular hemorrhage (p=0.038), and K-MMSE (p=0.007)-were predisposing factors for dysphagia in patients with aSAH.ConclusionAbnormalities in the oral phase were more prominent in patients with aSAH than in those with other types of stroke. The risk factors associated with dysphagia persisting over 6 months after stroke onset were the initial GCS, hemorrhage volume, presence of intraventricular hemorrhage, and cognitive status as measured by the K-MMSE.

show abstract

Acquisition of oral intake in severely dysphagic patients with acute stroke: A single-center, observational study involving a database of 4972 consecutive stroke patients

Cited by 14 publications

References 30 publications

The Role of Electrophysiologic Evaluation in Dysphagia Diagnosis in Acute Stroke Patients

The Role of Electrophysiologic Evaluation in Dysphagia Diagnosis in Acute Stroke Patients

Secular Trends in Ischemic Stroke Subtypes and Stroke Risk Factors

Characteristics of Patients With Aneurysmal Subarachnoid Hemorrhage and Risk Factors Related to Dysphagia

Contact Info

Product

Resources

About