Dysphagia and Associated Pneumonia in Stroke Patients from Brazil: A Systematic Review

Pacheco-Castilho, Aline Cristina; Vanin, Gabriela de Martini; Dantas, Roberto Oliveira; Pontes-Neto, Octávio Marques; Martino, Rosemary

doi:10.1007/s00455-019-10021-0

Cited by 21 publications

(26 citation statements)

References 52 publications

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“…9 The estimates obtained in this systematic review is also higher than some studies in emerging countries such as South Africa (53%), 25 and Brazil (59 -76%). 14 The rate of pneumonia in India was found to be between 22.8 to 32%, which is twice as higher than the global pneumonia rate (15%), and also was higher when compared to other emerging countries such as Brazil (15%), 26 and Chile (23%). 27 However, this increased pneumonia risk in India could only be derived from two studies.…”

Section: Discussionmentioning

confidence: 83%

Dysphagia and associated pneumonia in stroke patients from India

Krishnamurthy

Premkumar

Balasubramanium

2020

Preprint

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Background: India has high incidence (116-163 per 100,000) of stroke compared to western countries. Stroke is reported to be the fourth leading cause of death and fifth leading cause of disability in India. Dysphagia is seen approximately in half of the stroke patients and if unidentified may result in pulmonary complications such as aspiration pneumonia. However, there is no estimate of post stroke dysphagia and associated pneumonia in India. Method: Using the PRISMA methodology, a systematic search for recent literature on dysphagia in stroke was carried out across all the major databases. Two authors independently screened the titles and the abstracts, and those selected articles were assessed for quality using the GRADE approach. Comparisons were made of reported dysphagia and pneumonia frequencies, the relative risks of developing pneumonia were calculated. Data on duration of hospital stay and rates of mortality were also extracted. Results: We identified 86 citations, out of which only four articles were deemed eligible for critical analyses and data extraction. A high incidence (11.1% - 87.5%) of dysphagia was observed among stroke patients. Only two studies reported on incidence of pneumonia (22.8% - 32%); only one study stratified patients by both dysphagia and pneumonia. A relative risk of 5.82 (95% CI 4.6, 7.2) was found for pneumonia in patients with stroke and dysphagia. Data on length of hospital stay and rates of mortality secondary to aspiration pneumonia are also presented. Conclusion: Despite high incidence of dysphagia and associated pneumonia the methodological quality of studies are low. There is a dire need for methodologically sound studies to accurate determine the incidence of dysphagia and its impact on stroke patients in India. Keywords: deglutition; deglutition disorders; dysphagia; stroke; incidence; india;

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Section: Discussionmentioning

confidence: 83%

Dysphagia and associated pneumonia in stroke patients from India

Krishnamurthy

Premkumar

Balasubramanium

2020

Preprint

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“…Thus, they are the most susceptible to developing bronchoaspiration and pneumonia 18 . However, most of the studies [18][19][20][21] use the presence of dysphagia instead of dysarthria as a predictive factor for pneumonia. In this study, though, there were limitations, as well as the absence of a trained professional in the health care team at the hospital admission to evaluate dysphagia.…”

Section: Resultsmentioning

confidence: 99%

Pneumonia risk factors in stroke patients

et al. 2020

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Purpose: to assess the demographic and clinical characteristics associated with the development of pneumonia in post-stroke patients hospitalized in a tertiary hospital, located in the Vale do São Francisco, that covers the states of Pernambuco and Bahia, Brazil. Methods: a unicentric, observational, analytical, cross-sectional study, based on the medical records of patients diagnosed with stroke and included in the Stroke Registry (RAVESS study). The statistical analysis was made with the chi-square test, Fisher’s exact test, and the analysis of variance, with the Bonferroni’s post-test, and P≤0.05. Results: data from 69 patients presented with acute stroke were collected, aged 63.2±16.8 years; 37 (53.6%) were females; the prevalence of pneumonia during hospital stay was estimated at 31.9% (95% confidence interval: 21.2-44.2%). In the univariate analysis of predictors for post-stroke pneumonia, the following were identified: older age (72.6±17.9 vs. 58.8±14.5; P = 0.001), lower response signal to the Glasgow Coma Scale at admission (11.3±1.8 vs. 13.3±2.1; P = 0.001), and higher frequency of dysarthria at admission (61.9% vs. 27.9%; P = 0.009). Conclusion: pneumonia was a prevalent complication in post-stroke patients at a Brazilian tertiary hospital. It was related to the patient’s older age and the severity of the cerebral event.

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“…Dysphagia is one of the most common clinical complications after stroke, and the dysphagia after stroke can occur up to 80% of patients 21 . It has been well believed that dysphagia is closely associated with aspiration, pneumonia after stroke and malnutrition 22 .…”

Section: Discussionmentioning

confidence: 99%

Capsaicin combined with ice stimulation improves swallowing function in patients with dysphagia after stroke: A randomised controlled trial

Cui

Yin

et al. 2020

J of Oral Rehabilitation

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Background Dysphagia is a common condition after stroke, and it is associated with many complications. Early and effective treatments are essential to the prognosis of patients with dysphagia. We aimed to evaluate the effects and safety of capsaicin combined with ice stimulation in patients with dysphagia after stroke. Methods Patients with dysphagia admitted to our hospital from December 2017 to December 2019 were included. The control group received the ice stimulation, and the experimental group received the combined capsaicin and ice stimulation. The grade of water swallowing test (WST), standard swallowing assessment (SSA) scores and the serum substance P level was compared between control (ice only) and experimental group (capsaicin plus ice). Results No differences before treatment and significance following treatment in each group (before and after) and between groups (capsaicin plus ice vs ice only) were found (all P > .05); the SSA scores were significantly reduced after intervention for both groups (all P < .001), and after intervention, SSA score in experimental group was significantly less than that of control group (P < .001). After intervention, the number of patients graded as WST level I‐II in experimental group was significantly more than that of control group (P < .001); the serum substance P level was significantly increased after intervention for both groups (all P < .05), and after intervention, the serum substance P level in experimental group was significantly higher than that of control group (P = .007). Conclusions The combined use of capsaicin with ice stimulation is beneficial to the recovery of swallowing function of patients with dysphagia, which should be included into the clinical practice.

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Dysphagia and Associated Pneumonia in Stroke Patients from Brazil: A Systematic Review

Cited by 21 publications

References 52 publications

Dysphagia and associated pneumonia in stroke patients from India

Dysphagia and associated pneumonia in stroke patients from India

Pneumonia risk factors in stroke patients

Capsaicin combined with ice stimulation improves swallowing function in patients with dysphagia after stroke: A randomised controlled trial

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