Dysphagie

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

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

Cited by 10 publications

(1 citation statement)

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“…[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

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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.

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