Stroke severity and early recovery after first-ever ischemic stroke: Results of a hospital-based study in Taiwan

Tseng, Mei‐Chiun; Chang, Ku‐Chou

doi:10.1016/j.healthpol.2005.12.003

Cited by 27 publications

(16 citation statements)

References 16 publications

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“…This may be explained by the severity of the neurological injury. In a previous study, from the 70 patients with severe impairment (NIHSS score >15), 65 presented poor clinical evolution (9) , suggesting the use of the NIHSS as a predictor of outcomes of acute hospitalization (9,28) . Some studies have presented the NIHSS score between 11 and 12 as the cut-off point for risk of dysphagia (10) .…”

Section: Discussionmentioning

confidence: 92%

“…Some studies have presented the NIHSS score between 11 and 12 as the cut-off point for risk of dysphagia (10) . The use of the NIHSS is also suggested as an ideal marker in several studies that addressed the consequences of stroke (5,9,10,17,24,29) . Another study assessed the NIHSS score as a predictor for the use of percutaneous endoscopic gastrostomy (PEG) in hospitalized patients with acute ischemic stroke.…”

Section: Discussionmentioning

confidence: 99%

“…The NIHSS was used to assess the neurological status of patients according to the following scores: 0-6 was considered as minor stroke; 7-15, as moderate stroke, and ≥16, as severe stroke (9) . The scale used in the assessment of stroke severity was chosen because of its routine usage in the neurology department of the Institute.…”

Section: Methodsmentioning

confidence: 99%

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Association between neurological injury and the severity of oropharyngeal dysphagia after stroke

Otto

Ribeiro

Barea

et al. 2016

CoDAS

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Purpose: To associate the degree of biomechanical impairment in the swallowing process with the severity (National Institute of Health Stroke Scale -NIHSS) and type of neurological injury in patients post stroke. Methods: A cross-sectional, descriptive study conducted with 42 patients (22 females), aged 65.7 years on average diagnosed with stroke. All patients underwent clinical neurological evaluation and application of the NIHSS in the first 48 hours after stroke. The swallowing function was evaluated using the Functional Oral Intake Scale (FOIS) and the Protocol for the Investigation of Oropharyngeal Dysphagia in Adults. The Fisher's Exact Probability Test was used to assess the correlation between the degree of swallowing impairment and the severity (NIHSS score) and type of stroke. The study results were statistically analyzed at 5% significance level (p≤0.05). Results: 92.9% of the patients presented ischemic stroke; 59.5% presented impairment of the anterior cerebral circulation. Statistically significant correlation was found between the neurological scale (NIHSS) scores and the swallowing impairment scale (p=0.016). Conclusion: An association between stroke severity and oropharyngeal dysphagia severity was observed. A high proportion of patients with ischemic stroke with circulation affected in the anterior cerebral region presented severe oropharyngeal dysphagia. No statistically significant correlation was observed between the FOIS scale and stroke severity.

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Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 99%

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Association between neurological injury and the severity of oropharyngeal dysphagia after stroke

Otto

Ribeiro

Barea

et al. 2016

CoDAS

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“…Previous evidence has suggested that the worse the baseline is, the worse the outcomes are. Moderate to severe strokes had poorer outcomes [34, 35], greater demand of long-term care [36, 37], and higher expense of medical costs [38]. The acute and subacute stages constitute the golden recovery period for ischemic stroke.…”

Section: Discussionmentioning

confidence: 99%

Pilot Scheme of Health Policy in Stroke Adjuvant Acupuncture Therapy for Acute and Subacute Ischemic Stroke in Taiwan

Wei

Sun

Chang

et al. 2011

Evidence-Based Complementary and Alternative Medicine

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To reduce the health care burden of strokes, the Taiwan Department of Health launched the Pilot Scheme of the Health Policy in Stroke Adjuvant Acupuncture Therapy (HPSAAT) in 2006. This cross-sectional, hospital-based, match-controlled study at Chang Gung Memorial Hospital-Kaohsiung Medical Center during 2006∼2008 retrospectively evaluated the clinical characteristics of acute and subacute ischemic stroke patients who electively joined the HPSAAT. The study also evaluated the safety and clinical benefits of adjuvant acupuncture in treating acute and subacute ischemic stroke patients. Twenty-six HPSAAT participants and 52 age-sex matched random controls were enrolled. The stroke baseline of the HPSAAT participants was more severe than the non-HPSAAT controls. Although the stroke severity closely correlates to mortality and comorbidity, this study noted no significant complications in the HPSAAT participants during the acupuncture treatment course. Adjuvant acupuncture was considered safe at the acute and subacute stages of ischemic stroke. Due to uneven baseline severity, the clinical benefits in reducing neurological deficits and functional recovery were not concluded in this study.

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“…Later, the NIHSS was reapplied during the speech-language pathology assessment, in order to verify the level of consciousness, so that the results could be related to the swallowing data. To analyze the degree of neurological impairment assigned by the NIHSS, the following classification was used: 0-6 for mild stroke; 7-15 for moderate; 16 or more for severe stroke (10) . The research included patients diagnosed with ischemic stroke that arrived to the hospital emergency within 48 hours after the onset of symptoms, and who had stable clinical status at the time of the swallowing assessment.…”

Section: Clinical Case Presentationmentioning

confidence: 99%

Disfagia e acidente vascular cerebral: relação entre o grau de severidade e o nível de comprometimento neurológico

Itaquy

Favero

Ribeiro

et al. 2011

J. Soc. Bras. Fonoaudiol.

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O objetivo deste estudo foi verificar a ocorrência de disfagia após acidente vascular cerebral (AVC) isquêmico agudo durante as primeiras 48 horas de aparecimento dos sintomas para o estabelecimento de uma possível relação entre o nível de comprometimento neurológico e o grau de severidade da disfagia. Após a admissão hospitalar de emergência, três pacientes passaram por avaliação clínica neurológica, composta por exame físico geral, exame neurológico e aplicação da NationalInstitute of Health Stroke Scale (NIHSS); e avaliação clínica da deglutição por meio do Protocolo Fonoaudiológico de Avaliação do Risco para Disfagia (PARD). Dos pacientes avaliados, um apresentou deglutição funcional, com NIHSS 11, e dois apresentaram disfagia orofaríngea leve e moderada, sendo o NIHSS 15 e 19, respectivamente. O fluxo do serviço e a procura tardia dos pacientes por auxílio médico determinaram o baixo número de amostra. Os resultados obtidos confirmam os dados da literatura em relação à gravidade do paciente neurológico e à manifestação de disfagia.

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Stroke severity and early recovery after first-ever ischemic stroke: Results of a hospital-based study in Taiwan

Cited by 27 publications

References 16 publications

Association between neurological injury and the severity of oropharyngeal dysphagia after stroke

Association between neurological injury and the severity of oropharyngeal dysphagia after stroke

Pilot Scheme of Health Policy in Stroke Adjuvant Acupuncture Therapy for Acute and Subacute Ischemic Stroke in Taiwan

Disfagia e acidente vascular cerebral: relação entre o grau de severidade e o nível de comprometimento neurológico

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