Dysphagia and Nutritional Status at the Time of Hospital Admission for Ischemic Stroke

Background: Dysphagia and poor nutritional status occur frequently after stroke; however, potential associations between them are unknown. We evaluated potential associations between dysphagia and poor nutritional status in patients with acute ischemic stroke. Potential associations between these outcomes and more global stroke severity measures were also assessed. Methods: In all, 76 patients with acute ischemic stroke were recruited on admission to the dedicated stroke department of an academic medical center. All patients were assessed with a clinical swallowing evaluation, Functional Oral Intake Scale, Mini Nutritional Assessment, body mass index, percent body fat, National Institutes of Health Stroke Scale, modified Rankin Scale, and modified Barthel Index. Associations were evaluated among dysphagia, nutrition, and stroke severity measures. Results: On clinical examination 52.6% of study patients demonstrated dysphagia and 26.3% were identified with poor nutritional status. Dysphagia, based on clinical assessment, was associated with stroke severity (National Institutes of Health Stroke Scale, odds ratio [OR] 4.6, 95% confidence interval [CI] 1.6-13.1; modified Rankin Scale, OR 12.3, 95% CI 3.2-47.4) and with functional oral intake (OR 29.2, 95% CI 8.4-101.8), but not with measures of nutritional status (Mini Nutritional Assessment, OR 1.0, 95% CI 0.4-2.8). Nutritional measures did not correlate with swallowing or stroke severity measures. Conclusions: Dysphagia and poor nutritional status are prevalent in patients with acute ischemic stroke, however, they are not associated with each other at the time of hospital admission. Furthermore, dysphagia, but not nutritional status, is associated with stroke severity measures.

Key Words:  Ischemic stroke , dysphagia , nutritional status