Dysphagia in Acute Stroke: Incidence, Burden and Impact on Clinical Outcome.

Arnold, Marcel; Liesirova, Kai Timo; Broeg-Morvay, Anne; Meisterernst, Julia Anne; Schlager, Markus; Mono, Marie-Luise; El-Koussy, Marwan; Kägi, Georg; Jung, Simon; Sarikaya, Hakan (2016). Dysphagia in Acute Stroke: Incidence, Burden and Impact on Clinical Outcome. PLoS ONE, 11(2), e0148424. Public Library of Science 10.1371/journal.pone.0148424

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BACKGROUND Reported frequency of post-stroke dysphagia in the literature is highly variable. In view of progress in stroke management, we aimed to assess the current burden of dysphagia in acute ischemic stroke. METHODS We studied 570 consecutive patients treated in a tertiary stroke center. Dysphagia was evaluated by using the Gugging Swallowing Screen (GUSS). We investigated the relationship of dysphagia with pneumonia, length of hospital stay and discharge destination and compared rates of favourable clinical outcome and mortality at 3 months between dysphagic patients and those without dysphagia. RESULTS Dysphagia was diagnosed in 118 of 570 (20.7%) patients and persisted in 60 (50.9%) at hospital discharge. Thirty-six (30.5%) patients needed nasogastric tube because of severe dysphagia. Stroke severity rather than infarct location was associated with dysphagia. Dysphagic patients suffered more frequently from pneumonia (23.1% vs. 1.1%, p<0.001), stayed longer at monitored stroke unit beds (4.4±2.8 vs. 2.7±2.4 days; p<0.001) and were less often discharged to home (19.5% vs. 63.7%, p = 0.001) as compared to those without dysphagia. At 3 months, dysphagic patients less often had a favourable outcome (35.7% vs. 69.7%; p<0.001), less often lived at home (38.8% vs. 76.5%; p<0.001), and more often had died (13.6% vs. 1.6%; p<0.001). Multivariate analyses identified dysphagia to be an independent predictor of discharge destination and institutionalization at 3 months, while severe dysphagia requiring tube placement was strongly associated with mortality. CONCLUSION Dysphagia still affects a substantial portion of stroke patients and may have a large impact on clinical outcome, mortality and institutionalization.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology
04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic and Interventional Neuroradiology

UniBE Contributor:

Arnold, Marcel; Liesirova, Kai Timo; Broeg-Morvay, Anne; Meisterernst, Julia Anne; Schlager, Markus; Mono, Marie-Luise; El-Koussy, Marwan; Jung, Simon and Sarikaya, Hakan

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1932-6203

Publisher:

Public Library of Science

Language:

English

Submitter:

Martin Zbinden

Date Deposited:

08 Jun 2016 14:03

Last Modified:

08 Jun 2016 14:03

Publisher DOI:

10.1371/journal.pone.0148424

PubMed ID:

26863627

BORIS DOI:

10.7892/boris.81241

URI:

https://boris.unibe.ch/id/eprint/81241

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