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Geriatrics (Basel). 2019 Jul 9;4(3). pii: E42. doi: 10.3390/geriatrics4030042.

Natural History of Swallow Function during the Three-Month Period after Stroke.

Author information

1
Gastrointestinal Physiology Laboratory, Department of Surgery, Hospital de Mataró, Universitat Autònoma de Barcelona, 08304 Mataró, Spain.
2
Centro de Investigación Biomédica en Red de enfermedades hepáticas y digestivas (CIBERehd), Instituto de Salud Carlos III, 08036 Barcelona, Spain.
3
Neurology Unit, Hospital de Mataró, Universitat Autònoma de Barcelona, 08304 Mataró, Spain.
4
Gastrointestinal Physiology Laboratory, Department of Surgery, Hospital de Mataró, Universitat Autònoma de Barcelona, 08304 Mataró, Spain. pere.clave@ciberehd.org.
5
Centro de Investigación Biomédica en Red de enfermedades hepáticas y digestivas (CIBERehd), Instituto de Salud Carlos III, 08036 Barcelona, Spain. pere.clave@ciberehd.org.
6
Fundació Institut d'Investigació en Ciències de la Salut, Germans Trias i Pujol, 08916 Badalona, Spain. pere.clave@ciberehd.org.

Abstract

Oropharyngeal dysphagia is a prevalent complication following stroke (PS-OD), and one that is sometimes spontaneously recovered. This study describes the natural history of PS-OD between admission and three months post-stroke, and the factors associated with its prevalence and development. PS-OD was assessed with the volume-viscosity swallow test (V-VST) in all stroke patients on admission and at the three-month follow-up. We analyzed clinical, demographic, and neuroanatomical factors of 247 older post-stroke patients (National Institute of Health Stroke Scale (NIHSS) = 3.5 ± 3.8), comparing among those with PS-OD the ones with and without spontaneous recovery. PS-OD prevalence on admission was 39.7% (34.0% impaired safety; 30.8%, efficacy) and 41.7% (19.4% impaired safety; 39.3%, efficacy) at three months. Spontaneous swallow recovery occurred in 42.4% of patients with unsafe and in 29.9% with ineffective swallow, associated with younger age and optimal functional status. However, 26% of post-stroke patients developed new signs/symptoms of ineffective swallow related to poor functional, nutritional and health status, and institutionalization. PS-OD prevalence on admission and at the three-month follow-up was very high in the study population. PS-OD is a dynamic condition with some spontaneous recovery in patients with optimal functional status, but also new signs/symptoms can appear due to poor functionality. Regular PS-OD monitoring is needed to identify patients at risk of nutritional and respiratory complications.

KEYWORDS:

deglutition; deglutition disorders; function recovery; neurophysiology; stroke

PMID:
31324004
DOI:
10.3390/geriatrics4030042
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