Lesion location and other predictive factors of dysphagia and its complications in acute stroke

Fernández-Pombo, Antía; Seijo-Raposo, Iván; López-Osorio, Nuria; Cantón-Blanco, Ana; González-Rodríguez, María; Rivas, Susana; Rodríguez‐Yáñez, Manuel; Santamaría-Nieto, Alicia; Díaz-Ortega, Carmen; Gómez-Vázquez, Eva; Olmos, Miguel

doi:10.1016/j.clnesp.2019.05.019

Cited by 31 publications

(26 citation statements)

References 28 publications

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“…In our investigation, age, MMSE, and CCAT variables may have been correlated, but they were not statistically significant on the multivariable logistic regression and insufficiently powerful to predict NGT removal. Our findings also showed that NGT removal did not significantly correlate with stroke type (infarct or hemorrhage), a finding that is consistent with previous research findings [ 24 , 25 ]. In terms of the EQ-5D quality of life assessment, anxiety/depression was significantly different between the two groups.…”

Section: Discussionsupporting

confidence: 93%

Predictive Factors for Nasogastric Tube Removal in Post-Stroke Patients

et al. 2023

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Background and Objectives: Stroke patients have different levels of functional impairment, and rehabilitation is essential to achieving functional recovery. Many post-stroke patients transition from acute treatment to post-acute care (PAC) with nasogastric tubes (NGTs) for rehabilitation. However, long-term NGT placement can lead to several complications, and its earlier removal can effectively reduce the incidence of mortality. This study aimed to use a PAC–cerebrovascular disease (CVD) program and physical functional evaluation scale tools to demonstrate the factors associated with NGT removal before post-stroke patient discharge. Materials and Methods: In this retrospective cohort study, data were collected between January 2017 and August 2022. We divided patients who had NGTs at admission into discharged with and without NGT groups to compare their baseline characteristics and physical functional status. Logistic regression analysis was used to detect the predictive factors for NGT removal. Results: There were 63 participants: 22 without NGT removal and 41 with NGT removal. The NGT removal rate was 65%. Age and scores for the activities of daily living by the Barthel index (BI), Functional Oral Intake Scale (FOIS), Mini-Mental State Examination, and Concise Chinese Aphasia Test were significantly different in terms of NGT removal status, but only the BI and FOIS were significantly correlated with NGT removal. Patients’ BI scores indicating severe to moderate dependence (21–90) had a 4.55 times greater chance of NGT removal (odds ratio, 4.55; p < 0.05) than patients who had total dependence (<20). Every one-point increase in FOIS score indicated a 3.07 times greater chance of NGT removal (odds ratio, 3.07; p < 0.05). Conclusions: The BI and FOIS evaluations may indicate the probability of NGT removal in patients.

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Section: Discussionsupporting

confidence: 93%

Predictive Factors for Nasogastric Tube Removal in Post-Stroke Patients

et al. 2023

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“…Our finding that type of stroke (infarct or hemorrhage) had no significant effect on nasogastric tube removal in patients with dysphagia is similar to those of previous studies [ 8 , 11 ]. Several studies have shown no significant association between the lateralization of brain injury and dysphagia [ 11 , 12 ].…”

Section: Discussionsupporting

confidence: 92%

Predictors of nasogastric tube removal in patients with stroke and dysphagia

Lee¹,

Liu²,

Tzeng

et al. 2021

International Journal of Rehabilitation Research

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Dysphagia is present in 25–50% of patients with stroke. Therefore, studying the probability of nasogastric tube removal in such patients before discharge from the rehabilitation ward is crucial. In this study, we developed a model to predict the outcome of dysphagia in patients with stroke. A retrospective study was performed from May 2015 to December 2018. We reviewed the medical charts of all patients with a diagnosis of stroke receiving nasogastric tube feeding. Patients were divided into weaned and nonweaned groups to compare baseline characteristics and functional status. The weaned and nonweaned groups comprised 55 and 65 patients, respectively. In the final logistic regression analysis model, the Barthel index at admission, lip closing status, ability to answer simple questions and functional independence before stroke were used to develop a predictive model (Logit = 0.8942 × functional independence before this stroke + 1.1279 × ability to answer simple question + 0.5345 × lip-close status + 0.0546 × Barthel index at admission − 2.2805). The optimal cutoff point based on Youden’s index was more than −0.8403 with a sensitivity and specificity of 85.45 and 73.85%, respectively. The positive predicted value was 73.44%. In patients with stroke and dysphagia, a high Barthel index, intact lip closing status, ability to answer simple questions and better functional status before stroke appeared to affect nasogastric tube removal before discharge from the rehabilitation ward. Based on the final regression model, the proposed equation will help physicians and speech pathologists in planning patient care.

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“…It is now increasingly recognized that unilateral hemispheric affectation can cause dysphagia. [19,21] The present study also showed that the laterality of neurological deficit did not influence the development of dysphagia. Studies by Suntrup et al [22] suggest that swallowing is represented…”

Section: Figure 2: Kaplan-meier Survival Curve For Dysphagic and Non-dysphagic Stroke Patientssupporting

confidence: 68%

The Contribution of Dysphagia to Acute Stroke Morbidity and Mortality in Nigeria: A Prospective Study

Adebayo¹,

Taiwo²,

Owolabi³

et al. 2021

Ann Health Res

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Background: The assessment of time-trend morbidity and mortality in acute stroke is critical to clinical policy decisions and resource allocation. Objectives: To determine the prevalence of dysphagia in acute stroke and the impact of dysphagia on short term stroke outcome (30 days post-stroke). Methods: This was a prospective longitudinal study. Bedside screening for dysphagia modified Rankin score (MRS) and Barthel Index (BI) were performed on acute stroke patients on day 1, day 7, day 14 and day 30 after stroke to determine the frequency of dysphagia. Patients with dysphagia were then compared with age- and gender-matched controls (stroke patients without dysphagia) in terms of stroke characteristics and 30-day outcome. Results: Of the recruited 200 patients, 99 (49.5%) had dysphagia. Patients with intracerebral haemorrhagic stroke had a significantly higher prevalence of dysphagia (64% vs 36%; p<0.001). At baseline, dysphagic patients had more severe (Mean NHISS score, 22.81 Vs 8.92; p=0.01) and subcortical strokes (57.1% vs 42.9%, p = 0.015). At 30 days after stroke, the mean MRS was significantly higher in the dysphagic stroke patients (3.8±1.02) compared to those without dysphagia (2.5±1.3), (p = 0.001)]. Case fatality was higher among the dysphagic (79.8% vs 15.84%; p = 0.001) and the mean survival time was lower (12.21 days) among the dysphagic group (p = 0.001) Conclusion: Severe stroke, subcortical stroke and haemorrhagic stroke types were significantly associated with dysphagia at baseline. Dysphagia adversely influenced 30-days morbidity and case fatality in this cohort of acute stroke patients.

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Lesion location and other predictive factors of dysphagia and its complications in acute stroke

Cited by 31 publications

References 28 publications

Predictive Factors for Nasogastric Tube Removal in Post-Stroke Patients

Predictive Factors for Nasogastric Tube Removal in Post-Stroke Patients

Predictors of nasogastric tube removal in patients with stroke and dysphagia

The Contribution of Dysphagia to Acute Stroke Morbidity and Mortality in Nigeria: A Prospective Study

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