Acute Dysphagia Following Reperfusion Therapies: A Prospective Pilot Cohort Study.

Abstract

Dysphagia is a well-documented sequela of stroke. Recent advancements in medical treatments for stroke include reperfusion therapies (endovascular thrombectomy (EVT) and thrombolysis). As outcomes following reperfusion therapies are typically measured via general functional scales, the pattern and progression of acute dysphagia following reperfusion therapies is less known. To determine the progression of acute dysphagia (0-72h) following reperfusion therapies and relationships between various stroke parameters and dysphagia,twenty-six patients were prospectively recruited across two EVT and thrombolysis centres in Brisbane, Australia. Dysphagia was screened via the Gugging Swallowing Screen (GUSS) at the bedside at three timepoints: 0-24h, 24-48h, and 48-72h post-reperfusion therapies. Across three groups (EVT only, thrombolysis only, or both), the incidence of any dysphagia within the first 24h of reperfusion therapy was 92.31% (n = 24/26), 91.30% (n = 21/23) by 48h, and 90.91% (n = 20/22) by 72h. Fifteen patients presented with severe dysphagia at 0-24h, 10 at 24-48h, and 10 at 48-72h. Whilst dysphagia was not significantly correlated to infarct penumbra/core size, dysphagia severity was significantly related to the number of passes required during EVT (p = 0.009).Dysphagia continues to persist in the acute stroke population despite recent advancements in technology aimed to reduce morbidity and mortality post-stroke. Further research is required to establish protocols for management of dysphagia post-reperfusion therapies.