Dysphagia in acute ischaemic stroke: severity, recovery and relationship to stroke subtype

Abstract

Dysphagia in stroke is linked with increased risk of pneumonia, increased length of stay and poorer outcomes. This study followed a cohort of 88 acute ischaemic stroke patients admitted to hospitals in Perth, Western Australia, over 30 days. There were 8/88 deaths (9%). Infections were treated in 25/80 survivors (31%). Presence and severity of dysphagia were measured at 2 and 7 days post-stroke. Respiratory tract infections occurred at significantly higher rates for dysphagics ( p < 0.05). At 2 days post-stroke, the odds ratio (OR) of chest infection for dysphagics was 1.45 (95% CI = 1.07–1.98). Survivors who were “nil by mouth” 2 days post-stroke were significantly more likely to develop pneumonia ( p = 0.01). At 7 days post-stroke, dysphagics were again more likely to develop pneumonia ( p = 0.014) with OR = 1.77 (95% CI = 1.26–2.49). The total anterior circulation infarcts demonstrated more severe and prolonged dysphagia than other stroke subtypes.