Dysphagia screening decreases pneumonia in acute stroke patients admitted to the stroke intensive care unit
Journal
Journal of the Neurological Sciences
Journal Volume
306
Journal Issue
44198
Pages
38-41
Date Issued
2011
Author(s)
Huang K.-Y.
Chen C.-H.
Yip P.-K.
Abstract
Dysphagia increases the risk of pneumonia in stroke patients. This study aimed to evaluate bedside swallowing screening for prevention of stroke-associated pneumonia (SAP) in acute stroke patients admitted to the intensive care unit (ICU). Consecutive acute stroke patients admitted to the stroke ICU from May 2006 to March 2007 were included. Patients were excluded if they were intubated on the first day of admission or had a transient ischemic attack. A 3-Step Swallowing Screen was introduced since October 2006 and therefore patients were divided into pre-screen and post-screen groups. A binary logistic regression model was used to determine independent risk factors for SAP and in-hospital death. There were 74 and 102 patients included in the pre- and post-screen groups, respectively. Pneumonia was associated with higher National Institutes of Health Stroke Scale (NIHSS) score, older age, nasogastric and endotracheal tube placement. After adjusting for age, gender, NIHSS score and nasogastric and endotracheal tube insertion, dysphagia screening was associated with a borderline decrease in SAP in all stroke patients (odds ratio, 0.42; 95% CI, 0.18-1.00; p = 0.05). However, dysphagia screening was not associated with reduction of in-hospital deaths. Systematic bedside swallowing screening is helpful for prevention of SAP in acute stroke patients admitted to the ICU. ? 2011 Elsevier B.V. All rights reserved.
SDGs
Other Subjects
antibiotic agent; adult; age; aged; antibiotic therapy; aspiration pneumonia; conference paper; controlled study; disease association; drug use; dysphagia; endotracheal tube; female; hospital admission; human; intensive care unit; major clinical study; male; nasogastric tube; National Institutes of Health Stroke Scale; neuroprotection; priority journal; risk factor; screening test; sex difference; stroke associated pneumonia; stroke patient; swallowing; Aged; Aged, 80 and over; Deglutition Disorders; Female; Humans; Intensive Care Units; Logistic Models; Male; Middle Aged; Pneumonia; Retrospective Studies; Statistics, Nonparametric; Stroke; Taiwan
Type
conference paper