Association between neurological injury and the severity of oropharyngeal dysphagia after stroke

Abstract

Purpose: To associate the degree of biomechanical impairment in the swallowing process with the severity (National Institute of Health Stroke Scale -NIHSS) and type of neurological injury in patients post stroke. Methods: A cross-sectional, descriptive study conducted with 42 patients (22 females), aged 65.7 years on average diagnosed with stroke. All patients underwent clinical neurological evaluation and application of the NIHSS in the first 48 hours after stroke. The swallowing function was evaluated using the Functional Oral Intake Scale (FOIS) and the Protocol for the Investigation of Oropharyngeal Dysphagia in Adults. The Fisher's Exact Probability Test was used to assess the correlation between the degree of swallowing impairment and the severity (NIHSS score) and type of stroke. The study results were statistically analyzed at 5% significance level (p≤0.05). Results: 92.9% of the patients presented ischemic stroke; 59.5% presented impairment of the anterior cerebral circulation. Statistically significant correlation was found between the neurological scale (NIHSS) scores and the swallowing impairment scale (p=0.016). Conclusion: An association between stroke severity and oropharyngeal dysphagia severity was observed. A high proportion of patients with ischemic stroke with circulation affected in the anterior cerebral region presented severe oropharyngeal dysphagia. No statistically significant correlation was observed between the FOIS scale and stroke severity.

The Role of White Matter in the Neural Control of Swallowing: A Systematic Review

“…Further, even among healthy individuals, changes to white matter were associated with changes in swallowing control (i.e., total swallow duration and oral transit duration) (Levine et al, 1992 ). This finding is consistent with prior literature, supporting that severity of impairment from stroke (NIHSS score) moderately predicts clinically relevant dysphagia (Jeyaseelan et al, 2015 ), and lesion severity also predicts post-stroke dysphagia (Otto et al, 2016 ; Cabib et al, 2017 ; Rofes et al, 2018 ) and warrants further investigation.…”

Relação entre ingestão oral e gravidade do Acidente Vascular Cerebral Agudo

“…Studies suggest that swallowing difficulties are associated with increased length of hospital stay (18,19) , which is confirmed in this study, regarding the level of oral intake and the severity of the stroke. European authors emphasize that the validity of a screening test for swallowing in stroke may vary according to the severity of stroke in the studied population (20) .…”

Survey of suspected dysphagia prevalence in home-dwelling older people using the 10-Item Eating Assessment Tool (EAT-10)

“…It is thus likely that older people with decreased activities of daily living and cognitive function, and certified as requiring long-term care have impaired eating/swallowing functions, as well as impaired physical functions. Around 20% of individuals certified as requiring long-term care have late effects of cerebrovascular disease [27, 28]. Cerebrovascular disease is reportedly a common cause of dysphagia, with an increasing severity of late effects being associated with an increasing severity of dysphagia [28].…”

“…Around 20% of individuals certified as requiring long-term care have late effects of cerebrovascular disease [27, 28]. Cerebrovascular disease is reportedly a common cause of dysphagia, with an increasing severity of late effects being associated with an increasing severity of dysphagia [28]. Many of the individuals certified as requiring high-level care are known to have neuromuscular diseases, which are also associated with severe dysphagia [29].…”