Dysphagia and aspiration pneumonia in elderly hospitalization stroke patients: Risk factors, cerebral infarction area comparison

Xu, Zeqin; Gu, Yongquan; Li, Jianxin; Wang, Chunmei; Rong, Wang; Huang, Ying Zu; Zhang, Jian

doi:10.3233/bmr-170801

Cited by 27 publications

(25 citation statements)

References 27 publications

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“…The well-known factors that can increase the risk of aspiration pneumonia after stroke are increased age, a higher degree of cognitive impairment, low levels of substance P or the use of angiotensin-converting enzyme inhibitors, increased severity of aspiration and dysphagia, and increased levels of post-stroke disability [5][6][7][27][28][29]. Our study's results were consistent with those of previous studies, re ected by the lower GUSS and higher PAS and NIHSS scores in the elderly group and the increased severity of the oral stage of impairment in the younger age stroke group with higher initial mRS scores.…”

Section: Discussionmentioning

confidence: 99%

“…For example, low Mini-Mental State Examination (MMSE) scores were signi cantly associated with aspiration pneumonia in supratentorial infarction, and low modi ed Barthel Index (MBI) scores and aspiration signs in video uoroscopic swallowing studies (VFSSs) and salivagrams were signi cant predictors of infratentorial infarction. Similarly, a study of elderly stroke patients showed that multiple previous episodes of infarctions, high National Institutes of Health Stroke Scale (NIHSS) scores, and masticatory muscle paralysis were associated with poststroke aspiration pneumonia [7]. However, whether individual single nucleotide polymorphisms (SNPs) can also increase this risk and make certain individuals more vulnerable than others to respiratory complications is yet to be proven.…”

Section: Introductionmentioning

confidence: 99%

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Apolipoprotein E4 polymorphism is associated with a higher risk of aspiration pneumonia in young stroke patients

Park

Kim

et al. 2022

Preprint

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Background Genetic polymorphisms may be associated with infections, and some genes are known to be associated with pneumonia. Aspiration pneumonia is one of the major complications after stroke, and this study aimed to evaluate genetic effects on post-stroke aspiration pneumonia. Methods Blood samples were obtained from a total of 206 post-stroke participants (males, n = 136; mean age, 63.8 years). Genotyping was done for catechol-O-methyltransferase (rs4680 and rs165599), dopamine receptors (DRD1; rs4532, DRD2; rs1800497, DRD3, rs6280), brain-derived neurotrophic factor (rs6265), apolipoprotein E (rs429358, rs7412), and the interleukin-1 receptor antagonist gene (rs4251961). The subjects were stratified into two groups, aged < 65 (young) and ≥ 65 (elderly) years. Functional parameters and swallowing outcomes were measured at enrollment and 3-months post-onset. The primary outcome was the incidence of aspiration pneumonia. Results Analysis of the association between genetic polymorphisms and aspiration pneumonia history showed that a minor C rs429358 allele was associated with the occurrence of aspiration pneumonia in the young group, both in the additive and dominant models (odds ratio [OR], 4.53; 95% Confidence Interval [CI]: 1.60 – 12.84, P = 0.004). In the multivariable logistic analysis, a minor C rs429358 allele increased the risk of post-stroke aspiration pneumonia by 5.35 (95% CI: 1.64 – 20.88). In contrast, no genetic effects were seen in the elderly group. Conclusions A minor C rs429358 allele in young age stroke patients may increase the incidence of post-stroke aspiration pneumonia. Genetic polymorphism may provide useful information on how certain individuals are at increased risk of post-stroke aspiration pneumonia. Clinical Trial Registration-URL: https://www.clinicaltrials.gov. Unique identifier: NCT0357744

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Apolipoprotein E4 polymorphism is associated with a higher risk of aspiration pneumonia in young stroke patients

Park

Kim

et al. 2022

Preprint

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“…Stroke associated pneumonia (SAP) is one of the most fatal complications of stroke (90), and a high NIHSS score (91), dysphagia (91), and proton-pump inhibitor use (92) were found to be correlated with an increased risk of aspiration pneumonia. Disturbance of consciousness after stroke, aspiration caused by swallowing dysfunction and immunosuppression caused by stroke are considered to be the main pathogenesis of SAP (93).…”

Section: Complications and Managementmentioning

confidence: 99%

Enteral nutrition management in stroke patients: a narrative review

Gong¹,

Wang²,

Shi³

2021

Ann Palliat Med

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“…Stroke is one of the leading causes of disability and mortality worldwide ( 1 , 2 ). The number of stroke patients is gradually increasing around the world, leading to increases in healthcare costs ( 3 ).…”

Section: Introductionmentioning

confidence: 99%

The Relationship Between Dysphagia and Pneumonia in Acute Stroke Patients: A Systematic Review and Meta-Analysis

et al. 2022

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BackgroundDysphagia is a common complication after stroke and is associated with the development of pneumonia. This study aimed to summarize the relationship between dysphagia and pneumonia in post-stroke patients.Materials and MethodsArticles published up to November 2021 were searched in the PubMed, Embase, Cochrane library, and Scopus databases. Studies that investigated the development of pneumonia in acute stroke patients with and without dysphagia were included. The methodological quality of individual studies was evaluated using the Risk Of Bias In Non-randomized Studies-of Interventions tool, and publication bias was evaluated using a funnel plot and Egger's test.ResultsOf 5,314 studies, five studies were included in the meta-analysis. The results revealed that the incidence of pneumonia was significantly higher in the dysphagia group than in the non-dysphagia group (OR 9.60; 95% CI 5.75–16.04; p < 0.0001; I2 = 78%). There was no significant difference in the mortality rate between the two groups (OR 5.64; 95% CI 0.83–38.18; p = 0.08; I2 = 99%).ConclusionDysphagia is a significant risk factor for pneumonia after stroke. The early diagnosis and treatment of dysphagia in stroke patients are important to prevent stroke-associated pneumonia.

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Dysphagia and aspiration pneumonia in elderly hospitalization stroke patients: Risk factors, cerebral infarction area comparison

Abstract: In stroke inpatients over sixty years of age, it is necessary to distinguish the patients with multiple previous cerebral infarctions, high NIHSS score, masticatory muscle paralysis, abolition of gag reflex for early detection and rehabilitation of dysphagia.

Cited by 27 publications

References 27 publications

Apolipoprotein E4 polymorphism is associated with a higher risk of aspiration pneumonia in young stroke patients

Apolipoprotein E4 polymorphism is associated with a higher risk of aspiration pneumonia in young stroke patients

Enteral nutrition management in stroke patients: a narrative review

The Relationship Between Dysphagia and Pneumonia in Acute Stroke Patients: A Systematic Review and Meta-Analysis

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