The high prevalence of dysphagia after stroke leads to increased mortality, and cerebral reperfusion therapy has been effective in reducing neurologic deficits. The aim of this study was to investigate the severity and evolution of dysphagia and the occurrence of pneumonia in patients submitted to cerebral reperfusion therapy.
Seventy ischemic stroke patients were evaluated. Of these, 35 patients (group 1) were submitted to cerebral reperfusion therapy and 35 (group 2) did not receive thrombolytic treatment. The following were evaluated: severity of dysphagia by means of videofluoroscopy, evolution of oral intake rate by means of the Functional Oral Intake Scale, and the occurrence of pneumonia by international protocol. The relation between the severity of dysphagia and the occurrence of pneumonia with the treatment was evaluated through the chi-square test; the daily oral intake rate and its relation to the treatment were assessed by the Mann–Whitney test and considered significant if P is less than .05.
The moderate and severe degrees of dysphagia were more frequent (P = .013) among the patients who were not submitted to cerebral reperfusion therapy. The daily oral intake evolved independently of the treatment type, without statistical significance when compared between the groups, whereas pneumonia occurred more frequently in group 2 (28%) in relation to group 1 (11%) and was associated with the worst degrees of dysphagia (P = .045).
We can conclude that there is improvement in the oral intake rate in both groups, with lower severity of dysphagia and occurrence of pneumonia in ischemic stroke patients submitted to cerebral reperfusion therapy.
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- Heart disease and stroke statistics—2013 update: a report from the American Heart Association.Circulation. 2013; 127: 6-245
- Stroke and ischemic heart disease mortality trends in Brazil from 1979 to 1996.Neuroepidemiology. 2003; 22: 179-183
- Stroke Scale, Modified Rankin Scale and Barthel Index in Brazil: the role of cultural adaptation and structured interviewing.Cerebrovasc Dis. 2009; 27: 119-122
- Trends of stroke subtypes mortality in Sao Paulo, Brazil (1996-2003).Arq Neuropsiquiatr. 2005; 63: 951-955
- Estimates of the prevalence of acute stroke impairments and disability in a multiethnic population.Stroke. 2001; 32: 1279-1284
- Aspiration in patients with acute stroke.Arch Phys Med Rehabil. 1998; 79: 14-19
- Incidence of oropharyngeal dysphagia associated with stroke in a regional hospital in São Paulo State—Brazil.Arq Neuropsiquiatr. 2004; 62: 503-506
- Dysphagia after stroke: incidence, diagnosis, and pulmonary complications.Stroke. 2005; 36: 2756-2763
- The effect of pneumonia on mortality among patients hospitalized for acute stroke.Neurology. 2003; 60: 620-625
- Mortality and cost of pneumonia after stroke for different risk groups.J Stroke Cerebrovasc Dis. 2012; 21: 61-67
- Dysphagia, nutrition, and hydration in ischemic stroke patients at admission and discharge from acute care.Dysphagia. 2013; 28: 69-76
- Tissue plasminogen activator for acute ischemic stroke. The National Institute of Neurological Disorders and Stroke rt-PA Stroke Study Group.N Engl J Med. 1995; 333: 1581-1587
- Thrombolysis with alteplase 3 to 4.5 hours after acute ischemic stroke.N Engl J Med. 2008; 359: 1317-1329
- Modified barium swallow: clinical and radiographic correlation and relation to feeding recommendations.Dysphagia. 1996; 11: 187-190
- Initial psychometric assessment of a Functional Oral Intake Scale for dysphagia in stroke patients.Arch Phys Med Rehabil. 2005; 86: 1516-1520
- Nosocomial pneumonia after acute stroke: implications for neurological intensive care medicine.Stroke. 2003; 34: 975-981
- CDC/NHSN surveillance definition of health care associated infection and criteria for specific types of infections in the acute care setting.Am J Infect Control. 2008; 36: 309-332
- Using the National Institute of Health Stroke Scale to predict dysphagia in acute ischemic stroke.Cerebrovasc Dis. 2012; 33: 501-507
- Characteristics and outcome of patients with early complete neurological recovery after thrombolysis for acute ischemic stroke.Cerebrovasc Dis. 2011; 31: 185-190
- Role of cerebral cortex plasticity in the recovery of swallowing function following dysphagic stroke.Dysphagia. 2009; 24: 83-90
- The outcome of patients with mild stroke improves after treatment with systemic thrombolysis.PLoS One. 2013; 8: e59420
- Stroke-associated pneumonia: major advances and obstacles.Cerebrovasc Dis. 2013; 35: 430-443
- Reduced risk of poststroke pneumonia in thrombolyzed stroke patients with continued statin treatment.Int J Stroke. 2012; ([Epub ahead of print])https://doi.org/10.1111/j.1747-4949.2012.00864.x
Published online: March 03, 2014
Accepted: December 19, 2013
Received: November 13, 2013
Grant support: None.
© 2014 National Stroke Association. Published by Elsevier Inc. All rights reserved.