Abstract P842: The Effectiveness of an Aspiration Pneumonia Prevention Program in Acute Ischemic Stroke Patients

Abstract

Background: Pneumonia after stroke leads to poor clinical outcome. The aspiration risk increases in patients with dysphagia. This study aims to evaluate the effects of pneumonia prevention program following acute ischemic stroke (AIS). Methods: This was a prospective pre/post intervention study. AIS patients aged > 18 years with swallowing difficulties were enrolled. The pneumonia prevention program consisted of respiratory muscle training and oral care protocols. The program was provided during a 2-week hospitalization in all participants. Cough flow measurements and oral health status were evaluated using Cough Peak Flow (CPF) and Oral Assessment Guide (OAG) score respectively. Outcomes were measured at baseline and 2 weeks after randomization. Pneumonia incidence was collected at baseline, 2 weeks, and 1, 3, 6, and 12 months. Data were analyzed using descriptive statistics and paired t- test. Results: Nine females and 7 males were recruited with a mean + SD age of 67.5 + 8.7 years old. Median initial NIHSS (min, max) was 9 (4, 15) and 9 (2, 15) at baseline and 2 weeks respectively. Oral Assessment Guide (OAG) score improved in 15 patients (93.7%). Higher Cough Peak Flow (CPF) (> 160 L/min) was found in 87.5%. The OAG score was significantly lower (p < 0.05) at 2 weeks showing a significant improvement. There was also a statistically significant improvement of CPF at 2 weeks (p < 0.001). No aspiration pneumonia was diagnosed during the study. Conclusions: Pneumonia prevention program was effective in improving oral health status and cough reflex following AIS. The program can be applied as early as possible. Further studies with larger sample size and a control group are required.