Predictive Factors of Swallowing Disorders and Bronchopneumonia in Acute Ischemic Stroke

Beharry, Avinash; Michel, Patrik; Faouzi, Mohamed; Küntzer, Thierry; Schweizer, Valérie; Diserens, Karin

doi:10.1016/j.jstrokecerebrovasdis.2019.04.025

Cited by 23 publications

(42 citation statements)

References 29 publications

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“…This implies that the male gender is more likely to receive recommendations for tube feeding. This is similar to previous studies that reported that the male gender was associated with post-stroke dysphagia, pneumonia, and feeding tube placement [27][28][29]. Our patients with bilateral hemisphere involvement were more likely to be in the not improved group (3 of 7) and none of them were in the well-maintained group.…”

Section: Discussionsupporting

confidence: 91%

Epiglottic Retroflexion is a Key Indicator of Functional Recovery of Post-stroke Dysphagia

et al. 2020

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Objective To evaluate the longitudinal changes of swallowing kinematics based on videofluoroscopic swallowing studies (VFSSs) in subacute stroke patients grouped according to the method of dietary intake.Methods Sixty-nine subacute stroke patients who had taken at least 2 successive VFSSs were included. Subjects were allocated into 3 groups according to the degree of swallowing function recovery—not improved group (tube feeding recommended to patients at both studies), improved group (tube feedings recommended initially to patients and oral feeding recommended at follow-up study), and well-maintained group (oral feeding at both studies recommended to patients). Initial VFSS was performed during the subacute stage of stroke, 1 to 12 weeks after the onset of stroke, and follow-up VFSS was performed at least once. Kinematic variables were calculated by two-dimensional motion analysis of multiple structures, including the hyoid bone, epiglottis, and vocal cord. Changes of kinematic variables were analyzed in serial VFSSs.Results At the initial VFSS, the well-maintained group showed significantly larger angles of epiglottic folding than the not improved group, while at the follow-up VFSS, the improved and the well-maintained groups showed significantly larger epiglottic folding angles than the not improved group. The distribution of epiglottic folding angles was in a dichotomous pattern, and each cluster was related to the swallowing function.Conclusion This study showed that improved epiglottic folding angles are associated with the recovery of the swallowing process and suitability for oral feeding among various kinematic variables in subacute stroke patients.

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Section: Discussionsupporting

confidence: 91%

Epiglottic Retroflexion is a Key Indicator of Functional Recovery of Post-stroke Dysphagia

et al. 2020

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“…Brainstem stroke and dysphagia after stroke 6 studies [ 13 – 15 , 19 – 21 ] evaluated the relationship between stroke site and dysphagia, and there was no statistical heterogeneity among the studies (I 2 = 0, P = 0.76). The fixed effect model was used for statistical analysis.…”

Section: Resultsmentioning

confidence: 99%

Risk factors of dysphagia in patients with ischemic stroke: A meta-analysis and systematic review

Yang

Pan

2022

PLoS ONE

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Background Dysphagia is a common yet serious complication in stroke patients. We aimed to conduct a meta-analysis and systematic review to evaluate the risk factors of dysphagia in patients with ischemic stroke, to provide insights to the clinical treatment and nursing care of dysphagia. Methods We searched PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI) and Wanfang Database, China Biomedical Literature Database (CBM) for studies on dysphagia in patients with ischemic stroke up to January 31, 2022. The quality of the literature was evaluated using the Newcastle-Ottawa scale. Meta-analysis was performed using RevMan 5.3 software. Results A total of 10 studies involving 4637 ischemic stroke patients were included, 1183(25.51%) patients had dysphagia after stroke. The synthesized outcomes showed that elder age (SMD = 0.42, 95%CI:0.34–0.50), hypertension (OR = 1.96, 95%CI:1.48–2.61), diabetes (OR = 1.83, 95%CI:1.47–2.28), brainstem stroke (OR = 2.12, 95%CI:1.45–3.09) were associated with dysphagia in patients with ischemic stroke (all P<0.05). There was no significant difference in the gender between dysphagia and no dysphagia patients (OR = 1.07, 95%CI:0.91–1.27, P = 0.40). Egger regression tests indicated there were no significant publication biases in the synthesized outcomes (all P>0.05). Conclusions Elder age, hypertension, diabetes and brainstem stroke are associated with the development of dysphagia in patients with ischemic stroke. Attention should be paid to the assessment and early intervention of those risk factors for dysphagia to improve the prognosis of stroke patients.

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“…For instance, efficacy in improving swallowing and poststroke depression have not been analysed in existing reviews 4 20. These complications are known to affect the quality of life of poststroke patients, particularly swallowing function, which increases the rate of institutionalisation and mortality 21 22. Third, we reported on subgroup analysis based on the treatment characteristics of CHM versus acupuncture.…”

Section: Discussionmentioning

confidence: 99%

Would integrated Western and traditional Chinese medicine have more benefits for stroke rehabilitation? A systematic review and meta-analysis

et al. 2021

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BackgroundStroke is a major cause of death or long-term disability worldwide. Many patients with stroke receive integrative therapy consisting of Western medicine (WM) and routine rehabilitation in conjunction with Chinese medicine (CM), such as acupuncture and Chinese herbal medicine. However, there is no available evidence on the effectiveness of the combined use of WM and CM interventions in stroke rehabilitation.AimsThe purpose of this meta-analysis is to evaluate the results of all individual studies to assess the combined use of CM and WM in stroke rehabilitation compared with WM only.MethodsThe Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines were followed. MEDLINE, EMBASE, Cochrane and China National Knowledge Infrastructure (CNKI) were searched. The included outcomes were dependency, motor function, depression and swallowing function. Subgroup analysis was performed, and publication bias was assessed using funnel plots.Summary of review58 studies and 6339 patients were included in the meta-analysis. Subgroup analysis revealed that combined therapy comprising both acupuncture and WM had a superior effect on improving dependency and swallowing function compared with standard WM therapy alone. Potential superiority of combined therapy comprising CM and WM in improving depression compared with standard WM therapy was also found.ConclusionsOur results indicate that the combined use of CM and WM could be more efficacious in stroke rehabilitation compared with the use of WM therapy alone. However, most studies were short in duration (2 to 4 weeks) and prone to different types of biases, which prevents making any conclusion regarding the long-term effects and raises concerns regarding true efficacy in context of high likelihood of Hawthorn bias. So, more randomised controlled trials with more rigorous design and longer duration of treatment and follow-up need to be conducted to compare WM alone versus WM and CM combined.PROSPERO registration numberCRD42020152050.

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Predictive Factors of Swallowing Disorders and Bronchopneumonia in Acute Ischemic Stroke

Cited by 23 publications

References 29 publications

Epiglottic Retroflexion is a Key Indicator of Functional Recovery of Post-stroke Dysphagia

Epiglottic Retroflexion is a Key Indicator of Functional Recovery of Post-stroke Dysphagia

Risk factors of dysphagia in patients with ischemic stroke: A meta-analysis and systematic review

Would integrated Western and traditional Chinese medicine have more benefits for stroke rehabilitation? A systematic review and meta-analysis

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