Diagnostik

Prosiegel, Mario; Weber, Susanne; Thiel, Monika M.; Ewerbeck, Caroline

doi:10.1007/978-3-540-89535-0_8

Cited by 2 publications

(2 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“… 30 , 31 , 32 , 33 There is, however, a significant selection bias in studies using instrumental assessment of swallowing in acute stroke patients, which can influence not only the prevalence of dysphagia and aspiration risk but also the specific findings of swallowing impairment. 5 Prolonged intubation, reduced vigilance, non‐compliance, medical contraindications to FEES (such as respiratory instability, cardiocirculatory instability, impending cerebral herniation and active upper respiratory tract bleeding), 34 early death or palliative care are not rare in acute stroke patients, limit the instrumental assessment of swallowing, and explain why our final study population had less severe strokes and less frequently had complications such as sICH and stroke‐associated pneumonia. Therefore, we hypothesize that the prevalence of early dysphagia in non‐selected ischaemic stroke patients undergoing MT is even higher than the one we found.…”

Section: Discussionmentioning

confidence: 99%

Early flexible endoscopic evaluation of swallowing after mechanical thrombectomy in stroke patients

Pinho,

Meyer,

Mall

et al. 2024

Ann Clin Transl Neurol

View full text Add to dashboard Cite

ObjectiveThe aims of the study were to (1) characterize the findings of flexible endoscopic evaluation of swallowing (FEES) in stroke patients undergoing mechanical thrombectomy (MT); (2) analyse the screening performance of the Standardized Swallowing Assessment (SSA); and (3) study the impact of FEES‐defined dysphagia on 3‐month outcomes.MethodsThis single‐centre study was based on a local registry of consecutive acute ischaemic stroke patients undergoing MT during a 1‐year period. Patients received FEES within 5 days of admission regardless of the result of dysphagia screening. We compared baseline demographic and clinical characteristics of patients with and without FEES‐defined dysphagia. We collected 3‐month modified Rankin Scale (mRS) and individual index values of the European Quality of Life 5 Dimensions (EQ‐5D‐iv). Using univariable and multivariable regression analyses we predicted 3‐month outcomes for presence of dysphagia and for FEES‐defined dysphagia severity.ResultsWe included 137 patients with a median age of 74 years, 43.1% were female, median NIHSS was 12 and successful recanalization was achieved in 92.7%. Stroke‐associated pneumonia occurred in 8% of patients. FEES‐defined dysphagia occurred in 81% of patients. Sensitivity of the SSA as a dysphagia screening was 67%. Presence of dysphagia and increasing severity of dysphagia were independently associated with increasing 3‐month mRS score. Increasing dysphagia severity dysphagia was independently associated with lower EQ‐5D‐iv.InterpretationEarly FEES‐defined dysphagia occurs in four in every five patients undergoing MT. SSA has a suboptimal dysphagia screening performance. Presence of dysphagia and increasing dysphagia severity predict worse functional outcome and worse health‐related quality‐of‐life.

show abstract

Section: Discussionmentioning

confidence: 99%

Early flexible endoscopic evaluation of swallowing after mechanical thrombectomy in stroke patients

Pinho,

Meyer,

Mall

et al. 2024

Ann Clin Transl Neurol

View full text Add to dashboard Cite

show abstract

“…Mit der Schluckendoskopie ist eine Visualisierung von normaler Nahrung bzw. von Speichel und Sekret möglich, was für die Indikationsstellung für eine Trachealkanüle von besonderer Bedeutung ist [ 46 ] . Derzeit existieren nur wenige kontrollierte Studien zur Behandlung einer NOD.…”

Section: Standards Der Schluckdiagnostikunclassified

Neurogene Dysphagie im Rahmen der Neurologischen Komplexbehandlung und strukturelle Komponenten eines Dysphagieprogrammes

et al. 2012

View full text Add to dashboard Cite

▼ Introduction: An important aim of the Stroke Unit concept is the standardisation of diagnostics in stroke patients in order to help the nursing staff , swallowing therapists, dieticians and doctors for an early identifi cation of neurogenic oropharyngeal dysphagia (NOD). This enables the team to initiate appropriate therapeutic measures and to avoid complications such as aspiration pneumonia and malnutrition. Methods: With regard to the clinical assessment of swallowing by nursing staff and swallowing therapists a standardized swallowing assessment for dsyphagic patients and a standardized clinical swallowing examination (CSE) according to validated criteria is recommended. The clinical assessments should be followed by specifi c technical examinations like the swallowing endoscopy and/or videofl uoroscopy. Results: Studies with severe dysphagic stroke patients show that age, neuroanatomical lesions and scoring parameters (clinical assessment and technical examination) are important to predict the outcome of patients. With regards to the grading of dysphagic stroke patients the functional communication measure swallowing (FCM) as well as the penetration-aspiration-scale (PAS) show in a multivariate analysis an AUC of 73 % for the endpoint "tube-feeding at the end of neurorehabilitation (FCM 1-3 at day 90)". In a longitudinal study for the implementation of a dyphagia programm in a certifi ed stroke unit a reduced rate of pneumonia and in-hospital-mortality could be seen. Discussion: Establishing the degree of penetration and aspiration, as well as further symptoms such as leaking and retention is one of the essential criteria in the assessment of dysphagia with subsequent pathophysiologically-orientated procedures for the functional treatment of the swallowing disorder. This also includes the diagnostic procedures necessary to decide upon invasive

show abstract

Diagnostik

Cited by 2 publications

References 0 publications

Early flexible endoscopic evaluation of swallowing after mechanical thrombectomy in stroke patients

Early flexible endoscopic evaluation of swallowing after mechanical thrombectomy in stroke patients

Neurogene Dysphagie im Rahmen der Neurologischen Komplexbehandlung und strukturelle Komponenten eines Dysphagieprogrammes

Contact Info

Product

Resources

About