The Incidence of Dysphagia in Patients Receiving Cerebral Reperfusion Therapy Poststroke

• Published in: Journal of stroke and cerebrovascular diseases Vol. 23; no. 6; pp. 1524 - 1528
• Main Authors: Ribeiro, Priscila W., MSc, Cola, Paula C., MD, Gatto, Ana R., MSc, da Silva, Roberta G., PhD, Luvizutto, Gustavo J., MSc, Braga, Gabriel P., MSc, Schelp, Arthur O., MD, Henry, Maria A. C. de Arruda, MD, Bazan, Rodrigo, MD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-07-2014
• Subjects: Aged; Brain Ischemia - complications; Brain Ischemia - therapy; Cardiovascular; deglutition; deglutition disorders; Deglutition Disorders - diagnosis; Deglutition Disorders - epidemiology; Deglutition Disorders - etiology; dysphagia; Female; Humans; Incidence; Male; Neurology; Pneumonia - diagnosis; Pneumonia - epidemiology; Pneumonia - etiology; Prospective Studies; Reperfusion; Severity of Illness Index; Stroke; Stroke - complications; Stroke - therapy; thrombolytic therapy; thrombolytic therapy; deglutition; dysphagia; Stroke; deglutition disorders
• ISSN: 1052-3057; 1532-8511
• DOI: 10.1016/j.jstrokecerebrovasdis.2013.12.033

Background The high prevalence of dysphagia after stroke leads to increased mortality, and cerebral reperfusion therapy has been effective in reducing neurologic deficits. The aim of this study was to investigate the severity and evolution of dysphagia and the occurrence of pneumonia in patients submitted to cerebral reperfusion therapy. Methods Seventy ischemic stroke patients were evaluated. Of these, 35 patients (group 1) were submitted to cerebral reperfusion therapy and 35 (group 2) did not receive thrombolytic treatment. The following were evaluated: severity of dysphagia by means of videofluoroscopy, evolution of oral intake rate by means of the Functional Oral Intake Scale, and the occurrence of pneumonia by international protocol. The relation between the severity of dysphagia and the occurrence of pneumonia with the treatment was evaluated through the chi-square test; the daily oral intake rate and its relation to the treatment were assessed by the Mann–Whitney test and considered significant if P  is less than .05. Results The moderate and severe degrees of dysphagia were more frequent ( P  = .013) among the patients who were not submitted to cerebral reperfusion therapy. The daily oral intake evolved independently of the treatment type, without statistical significance when compared between the groups, whereas pneumonia occurred more frequently in group 2 (28%) in relation to group 1 (11%) and was associated with the worst degrees of dysphagia ( P  = .045). Conclusions We can conclude that there is improvement in the oral intake rate in both groups, with lower severity of dysphagia and occurrence of pneumonia in ischemic stroke patients submitted to cerebral reperfusion therapy.