Background: Pneumonia is an important complication of ischemic stroke and increases mortality 3-fold. Five guidelines recommend a dysphagia screen before oral intake. What constitutes an adequate dysphagia screen and which patients should receive it remain unclear.
Methods: Fifteen acute care institutions prospectively collected data on all admitted patients with acute ischemic stroke. Sites were required to collect data on demographics and 4 quality indicators. Optional data included stroke severity and complications. We measured adherence to a screen for dysphagia, the type of screen, and development of in-hospital pneumonia.
Results: Between December 2001 and January 2003, 2532 cases were collected. In-hospital complications were recorded on 2329 (92%) of cases. Stroke severity was captured on 1361 (54%). Adherence to a dysphagia screen was 61%. Six sites had a formal dysphagia screen, and their adherence rate was 78% compared with 57% at sites with no formal screen. The pneumonia rate at sites with a formal dysphagia screen was 2.4% versus 5.4% (P=0.0016) at sites with no formal screen. There was no difference in median stroke severity (5 versus 4; P=0.84) between the sites with and without a formal screen. A formal dysphagia screen prevented pneumonia even after adjusting for stroke severity.
Conclusions: A formal dysphagia screen is associated with a higher adherence rate to dysphagia screens and a significantly decreased risk of pneumonia. A formal screening protocol should be offered to all stroke patients, regardless of stroke severity.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1161/01.STR.0000177529.86868.8d | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
CARP VIII antibody-related autoimmune cerebellar ataxia in a child after infection: a case report.
Front Immunol
January 2025
First Department of Pediatrics, Weifang People's Hospital Affiliated to Shandong Second Medical University, Weifang, China.
Autoimmune cerebellar ataxia (ACA) is a cerebellar syndrome induced by autoimmune reactions and its onset is induced by malignant tumors, prodromic infection, and gluten allergy. Its clinical symptoms include gait disorder, limb ataxia, dysarthria, and dysphagia. According to , the diagnosis of ACA is based on the following points: 1.
View Article and Find Full Text PDFA prospective study of diagnostic testing and hospital charges after brief resolved unexplained event.
J Pediatr Gastroenterol Nutr
January 2025
Institutional Centers for Clinical and Translational Research, Boston Children's Hospital, Boston, Massachusetts, USA.
Objectives: To evaluate diagnostic testing frequency/yield and determine drivers of hospital charges in a prospective cohort of infants with brief resolved unexplained event (BRUE) to test the hypothesis that length of stay (LOS), low-yield diagnostic testing, and repeat hospital visits increase costs.
Methods: We conducted a prospective cohort study of infants admitted after BRUE to determine how clinical practice impacts the cost of care. Charge data from our institution's billing records database included room and board, diagnostics, medications, and professional fees for index hospitalizations and 6-month follow-ups.
Diagnosis of chronic obstructive pulmonary disease (COPD) in older patients : Consensus statement of the Working Group on Pneumology in Older Patients.
Z Gerontol Geriatr
January 2025
Geriatrie, Universität Witten-Herdecke, Alfred Herrhausenstraße 50, 58455, Witten, Germany.
Chronic obstructive pulmonary disease (COPD) is a frequent disease from which approximately 8% of individuals aged 40 years and above suffer. The prevalence increases up to fivefold as age advances. Following an introduction including the etiology, measurement, characteristic features and classification of COPD, this article presents the consensus recommendations of the German Working Group on Pneumology in Older Patients.
View Article and Find Full Text PDFCorkscrew esophagus in an elderly patient: A case of diffuse esophageal spasm with literature review.
Radiol Case Rep
March 2025
College of Medicine, University of Baghdad, Baghdad, Iraq.
Diffuse esophageal spasm (DES) is a rare motility disorder characterized by uncoordinated esophageal contractions, often presenting with dysphagia and chest pain. This case describes a 70-year-old male who presented with atypical symptoms of DES, including episodic dysphagia to solids, postprandial vomiting, and chest pain triggered by cold liquids. Initially misdiagnosed as indigestion, further evaluation with barium swallow imaging revealed a "corkscrew" esophagus, leading to the diagnosis of DES.
View Article and Find Full Text PDFGiant Solitary Fibrous Tumor of the Retropharyngeal Space: A Case Report and Review of the Literature.
Ear Nose Throat J
January 2025
Department of Otolaryngology Head and Neck Surgery, Peking University First Hospital, Beijing, China.
Solitary fibrous tumor (SFT) is an uncommon spindle cell neoplasm, which generally arises from the pleura. There have been documented a number of extrapleural origins including the head and neck in the literature. It is emphasized to make a diagnosis in a rare location such as the retropharyngeal space.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!