Chest Infection Following Acute Stroke: Does Aspiration Matter?

Smithard, DG; Renwick, D.; Df, Martin; O'Neill, PA

doi:10.1093/ageing/22.suppl_3.p24-a

Cited by 15 publications

(9 citation statements)

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“…The results suggest that the doctor was overcautious, tending to categorize more patients as being at risk of aspiration. Furthermore, most patients with aspiration on VF were not identified at the bedside, though we have previously shown that it is the clinical not the radiological assessment that has the strongest association with death, the development of pneumonia, and poor functional recovery [8]. These associations remained even when other significant markers of stroke prognosis (incontinence, hemianopia, weakness, presence of neglect, and apraxia) were allowed for [8].…”

Section: Discussionmentioning

confidence: 99%

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The Natural History of Dysphagia following a Stroke

Smithard

O’Neill

England³

et al. 1997

Dysphagia

461

290

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To assess the frequency and natural history of swallowing problems following an acute stroke, 121 consecutive patients admitted within 24 hours of the onset of their stroke were studied prospectively. The ability to swallow was assessed repeatedly by a physician, a speech and language therapist, and by videofluoroscopy. Clinically 51% (61/121) of patients were assessed as being at risk of aspiration on admission. Many swallowing problems resolved over the first 7 days, through 28/110 (27%) were still considered at risk by the physician. Over a 6-month period, most problems had resolved, but some patients had persistent difficulties (6, 8%), and a few (2, 3% at 6 months) had developed swallowing problems. Ninety-five patients underwent videofluoroscopic examination within a median time of 2 days; 21 (22%) were aspirating. At 1 month a repeat examination showed that 12 (15%) were aspirating. Only 4 of these were persistent; the remaining 8 had not been previously identified. This study has confirmed that swallowing problems following acute stroke are common, and it has been documented that the dysphagia may persist, recur in some patients, or develop in others later in the history of their stroke.

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Section: Discussionmentioning

confidence: 99%

“…Only two studies have used both methods of evaluation [7,8], which confirmed the high incidence and complexity of swallowing problems immediately following stroke.…”

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confidence: 99%

The Natural History of Dysphagia following a Stroke

Smithard

O’Neill

England³

et al. 1997

Dysphagia

461

290

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“…Dysphagia is highly prevalent among elderly people. Researches show that about 27–64% of elderly people suffer from swallowing disorder (Singh & Hamdy, ; Smithard, Renwick, Martin, & O'neill, ; Wolfe, ). Consequences of dysphagia can be serious to individual patients (Andersen, Beck, Kjaersgaard, Hansen, & Poulsen, ).…”

Section: Introductionmentioning

confidence: 99%

Clinical applications of IDDSI framework for texture recommendation for dysphagia patients

Zheng

Chen

et al. 2017

Journal of Texture Studies

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Dysphagia is a highly prevalent eating and swallowing disorder among elderly people, impacting negatively on the health and well-being of those afflicted. With increasing populations of elderly people, food industries are under growing pressure to produce appropriately texture-modified food for safe consumption by these vulnerable populations. Recently published International Dysphagia Diet Standardisation Initiative (IDDSI) framework provides a new global guideline on texture modification and standardization for dysphagia patients. This work was designed to test the feasibility of IDDSI framework for clinical applications by assessing the correlation between swallowing capability of dysphagia patients and the IDDSI texture levels. Altogether 26 elderly subjects were recruited and assessed for their dysphagia grades using the Water Drinking Test. Practical applicationsSwallowing disorder or dysphagia occurs commonly among many elderly people and imposes negative impacts on their health and well-being. Medical professionals can diagnose eating and swallowing capability in a qualitative manner, but have difficulty in making diet recommendation because of the lack of texture guidance. This work confirmed the feasibility of IDDSI framework for clinical and bedside applications. The correlation between the capability grades of swallowing and IDDSI texture levels established in this work provides a useful measure for such applications. K E Y W O R D Sdysphagia, elderly, food oral processing, IDDSI, IDDSI framework, swallowing, texture modification

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“…Die klinische Erfahrung zeigt, dass multimorbide, gebrechliche Senioren mit Ernährungsrisiko von enteraler Sondenernährung profitieren, solange der Allgemeinzustand stabil ist. Auch Beobachtungsstudien liefern Hinweise auf eine relativ gute Prognose bei sondenernährten gebrechlichen Heimbewohnern in gutem Allgemeinzustand [41,55] Typische Komplikationen der neurologisch bedingten Dysphagie sind Aspiration mit bronchopulmonalen Infektionen [126 ± 129] und Malnutrition mit daraus resultierender verlängerter Krankenhausverweildauer und gehäuften Wiederaufnahmen ins Krankenhaus [128,130,131]. Die Mortalität infolge Dysphagie ist signifikant erhöht [128].…”

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