Real-world Effectiveness of Speech Therapy Time on Cognitive Recovery in Older Patients with Acute Stroke

Sakai, Kotomi; Momosaki, Ryo

doi:10.2490/prm.20160004

Cited by 5 publications

(2 citation statements)

References 30 publications

(28 reference statements)

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“…In this study, SLT was defined as at least one unit (equal to 20 min) of rehabilitation conducted by SLPs during hospitalization [17]. The sessions included swallowing and/or compensatory rehabilitation strategies, both of which are common approaches to treating dysphagia [18].…”

Section: Slt and Exposuresmentioning

confidence: 99%

Association between timing of speech and language therapy initiation and outcomes among post-extubation dysphagia patients: a multicenter retrospective cohort study

et al. 2022

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Background Post-extubation dysphagia (PED) is recognized as a common complication in the intensive care unit (ICU). Speech and language therapy (SLT) can potentially help improve PED; however, the impact of the timing of SLT initiation on persistent PED has not been well investigated. This study aimed to examine the timing of SLT initiation and its effect on patient outcomes after extubation in the ICU. Methods We conducted this multicenter, retrospective, cohort study, collecting data from eight ICUs in Japan. Patients aged ≥ 20 years with orotracheal intubation and mechanical ventilation for longer than 48 h, and those who received SLT due to PED, defined as patients with modified water swallowing test scores of 3 or lower, were included. The primary outcome was dysphagia at hospital discharge, defined as functional oral intake scale score < 5 or death after extubation. Secondary outcomes included dysphagia or death at the seventh, 14th, or 28th day after extubation, aspiration pneumonia, and in-hospital mortality. Associations between the timing of SLT initiation and outcomes were determined using multivariable logistic regression. Results A total of 272 patients were included. Of them, 82 (30.1%) patients exhibited dysphagia or death at hospital discharge, and their time spans from extubation to SLT initiation were 1.0 days. The primary outcome revealed that every day of delay in SLT initiation post-extubation was associated with dysphagia or death at hospital discharge (adjusted odds ratio (AOR), 1.09; 95% CI, 1.02–1.18). Similarly, secondary outcomes showed associations between this per day delay in SLT initiation and dysphagia or death at the seventh day (AOR, 1.28; 95% CI, 1.05–1.55), 14th day (AOR, 1.34; 95% CI, 1.13–1.58), or 28th day (AOR, 1.21; 95% CI, 1.07–1.36) after extubation and occurrence of aspiration pneumonia (AOR, 1.09; 95% CI, 1.02–1.17), while per day delay in post-extubation SLT initiation did not affect in-hospital mortality (AOR, 1.04; 95% CI, 0.97–1.12). Conclusions Delayed initiation of SLT in PED patients was associated with persistent dysphagia or death. Early initiation of SLT may prevent this complication post-extubation. A randomized controlled study is needed to validate these results.

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Section: Slt and Exposuresmentioning

confidence: 99%

Association between timing of speech and language therapy initiation and outcomes among post-extubation dysphagia patients: a multicenter retrospective cohort study

et al. 2022

View full text Add to dashboard Cite

show abstract

“…In this study, SLT was de ned as at least one unit (equal to 20 min) of rehabilitation conducted by SLPs during hospitalization [15]. The sessions included swallowing and/or compensatory rehabilitation strategies, both of which are common approaches to treating dysphagia [16].…”

Section: Slt and Exposuresmentioning

confidence: 99%

Association Between Timing of Speech and Language Therapy Initiation and Outcomes Among Post-Extubation Dysphagia Patients: A Multicenter Retrospective Cohort Study

Hongo

Yamamoto

Liu

et al. 2022

Preprint

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Background: Post-extubation dysphagia (PED) is recognized as a common complication in the intensive care unit (ICU). Speech and language therapy (SLT) can potentially help improve PED; however, the impact of the timing of SLT initiation on persistent PED has not been well investigated. This study aimed to examine the timing of SLT initiation and its effect on patient outcomes after extubation in the ICU.Methods: We conducted this multicenter, retrospective, cohort study, collecting data from eight ICUs in Japan from patients treated between 2017 and 2020. Patients aged ≥ 20 years with orotracheal intubation and mechanical ventilation for longer than 48 hours, and those who received SLT due to PED, defined as patients with modified water swallowing test scores of 3 or lower, were included. The primary outcome was dysphagia at hospital discharge, defined as functional oral intake scale score <5 or death after extubation. Secondary outcomes included dysphagia or death at the seventh, 14th, or 28th day after extubation, aspiration pneumonia, and in-hospital mortality. Associations between the timing of SLT initiation and outcomes were determined using multivariable logistic regression. Results: Two hundred and seventy-two patients met the study inclusion criteria. Of them, 82 (30.1%) patients exhibited dysphagia or death at hospital discharge, and their time spans from extubation to SLT initiation was 1.0 days. The primary outcome revealed that every day of delay in SLT initiation post-extubation was associated with dysphagia or death at hospital discharge (adjusted odds ratio (AOR), 1.09; 95% CI, 1.02 to 1.18). Similarly, secondary outcomes showed associations between this per day delay in SLT initiation and dysphagia or death at the seventh day (AOR, 1.28; 95% CI, 1.05 to 1.55), 14th day (AOR, 1.34; 95% CI, 1.13 to 1.58), or 28th day (AOR, 1.21; 95% CI, 1.07 to 1.36) after extubation and occurrence of aspiration pneumonia (AOR, 1.09; 95% CI, 1.02 to 1.17), while per day delay in post-extubation SLT initiation did not affect in-hospital mortality (AOR, 1.04; 95% CI, 0.97 to 1.12). Conclusions: Delayed initiation of SLT in PED patients was associated with persistent dysphagia or death. Early initiation of SLT may prevent this complication post-extubation.

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Association of Speech Therapy Time and Cognitive Recovery in Stroke Patients: A Comparison of Studies

Hori

Sakai

Ueda

et al. 2021

Journal of the American Medical Directors Association

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Real-world Effectiveness of Speech Therapy Time on Cognitive Recovery in Older Patients with Acute Stroke

Cited by 5 publications

References 30 publications

Association between timing of speech and language therapy initiation and outcomes among post-extubation dysphagia patients: a multicenter retrospective cohort study

Association between timing of speech and language therapy initiation and outcomes among post-extubation dysphagia patients: a multicenter retrospective cohort study

Association Between Timing of Speech and Language Therapy Initiation and Outcomes Among Post-Extubation Dysphagia Patients: A Multicenter Retrospective Cohort Study

Association of Speech Therapy Time and Cognitive Recovery in Stroke Patients: A Comparison of Studies

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