The Mortality and the Risk of Aspiration Pneumonia Related with Dysphagia in Stroke Patients

Feng, Ming-Chu; Lin, Yi‐Ching; Chang, Yo-Chen; Chen, Chun‐Hung; Chiang, Hsiu‐Chu; Huang, Ling‐Chun; Yang, Yuan‐Han; Hung, Chih‐Hsing

doi:10.1016/j.jstrokecerebrovasdis.2019.02.011

Cited by 112 publications

(98 citation statements)

References 16 publications

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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 . Therefore, patients with dysphagia need to be trained and intervened to improve swallowing function and restore their ability to eat.…”

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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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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“…Recent work in stroke has attempted to predict the influence of post-stroke dysphagia and other patient factors on unfavorable outcomes. There is an association of post-stroke dysphagia with increased mortality [ 22 , 28 , 30 , 34 , 37 , 56 – 58 ], overall unfavorable outcome [ 34 , 35 , 58 ], greater dependency [ 30 , 36 , 57 ], longer length of stay [ 33 , 36 ], less likely to discharge home [ 35 , 36 , 57 , 58 ], and modified diet or reliance on tube feeding [ 22 , 35 , 43 , 57 ]. Longer length of stay due to dysphagia may occur in patients whose medical evaluation is completed, but the medical team is waiting to see if the dysphagia will resolve or a percutaneous gastrostomy tube is needed, as many skilled nursing facilities will not admit patients reliant to tube feeding, but without a permanent feeding tube.…”

Section: What Are the Consequences Of Post-stroke Dysphagia?mentioning

confidence: 99%

Post-stroke Dysphagia: Recent Insights and Unanswered Questions

Jones¹,

Colletti

Ding

2020

Curr Neurol Neurosci Rep

101

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Purpose of Review We explored themes in recent post-stroke dysphagia literature, focusing on the following questions: (1) What does post-stroke dysphagia look like?; (2) Who gets post-stroke dysphagia?; (3) What are the consequences of post-stroke dysphagia?; and (4) How can we improve treatment of post-stroke dysphagia? Recent Findings There have been several improvements in quantitative descriptions of swallowing physiology using standard and new evaluation techniques. These descriptions have been correlated with lesion locations, and several factors can predict development of post-stroke dysphagia and its sequelae. Novel treatment paradigms have leveraged post-stroke neuroplastic improvements using neurostimulation and biofeedback techniques. Despite recent findings, the field is limited by lack of standardization and unanswered questions on rehabilitation variables. Summary Our improved understanding of post-stroke dysphagia will enhance our ability to prevent, identify, and treat it. Future work should be grounded in swallowing physiology and continue refining treatments, particularly in the acute stage.

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“…Schluckstörungen sind zudem mit einer hohen Morbidität und Mortalität behaftet. Sie können schwerwiegende Folgen wie Unterund Fehlernährung, Dehydrierung und eine Aspirationspneumonie aufweisen und schlimmstenfalls den Tod verursachen [23,24,25]. Nicht zu unterschätzen sind auch die Folgen einer gestörten Ta bletteneinnahme mit Wirkverlusten sowie lokalen Schleimhautirritationen durch unbemerktes "Hängenbleiben" [26].…”

Section: Folgen Von Dysphagienunclassified

Ausbildungscurriculum zum Zertifikat „Diagnostik und Therapie oropharyngealer Dysphagien, inklusive FEES“ der Deutschen Gesellschaft für Phoniatrie und Pädaudiologie und der Deutschen Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie

Graf

Keilmann²,

Dazert

et al. 2019

Laryngo-Rhino-Otol

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Zusammenfassung Hintergrund In Deutschland leiden ca. 5 Millionen Menschen jeden Lebensalters an einer Dysphagie. Durch den demografischen Wandel und die verbesserte medizinische Versorgung ist mit einer Zunahme der Inzidenz von Schluckstörungen zu rechnen. Die Dysphagie ist mit einer erhöhten Morbiditäts- und Mortalitätsrate assoziiert und führt zu einer erheblichen finanziellen Belastung der Gesundheitssysteme. Die zwei häufigsten Ursachen einer Schluckstörung sind neurologische Erkrankungen und Kopf-Hals-Tumore. Die Diagnostik und Therapie haben sich in den letzten Jahrzehnten kontinuierlich weiterentwickelt. Insbesondere die flexibel-endoskopische Beurteilung des Schluckaktes (FEES) ist zu einem festen Bestand in der Abklärung von Schluckstörungen geworden. Ergebnisse Das Zertifikat „Diagnostik und Therapie oropharyngealer Dysphagien, inkl. FEES“ wurde von der Deutschen Gesellschaft für Phoniatrie und Pädaudiologie (DGPP) und der Deutschen Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie (DGHNO KHC) in Zusammenarbeit mit dem Deutschen Berufsverband für Phoniatrie und Pädaudiologie und dem Deutschen Berufsverband der Hals-Nasen-Ohrenärzte entwickelt.Es besteht aus drei Teilen: den Modulen (A, B und C), der indirekten Supervision und einer praktischen Prüfung. Aufbau, detaillierte Inhalte und die Anforderungen zur Erlangung des Zertifikates werden im folgenden Artikel beschrieben. Ebenso werden die Qualifikationen der Dozenten und Prüfer festgesetzt. Fazit Die systematische Ausbildung dient der Qualitätssicherung und Etablierung von Standards in der Diagnostik und Therapie von oropharyngealen Dysphagien in der Phoniatrie und Pädaudiologie und in der Hals-, Nasen- Ohrenheilkunde.

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The Mortality and the Risk of Aspiration Pneumonia Related with Dysphagia in Stroke Patients

Cited by 112 publications

References 16 publications

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

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

Post-stroke Dysphagia: Recent Insights and Unanswered Questions

Ausbildungscurriculum zum Zertifikat „Diagnostik und Therapie oropharyngealer Dysphagien, inklusive FEES“ der Deutschen Gesellschaft für Phoniatrie und Pädaudiologie und der Deutschen Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie

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