Relationship Between Type of Ischemic Stroke with Degree of Dysphagia, Aspiration Pneumonia, and Mortality: A Three-Year Portuguese Stroke Unit Experience
DOI:
https://doi.org/10.24950/O/296/20/3/2021Keywords:
Deglutition Disorders/mortality, Pneumonia, Aspiration/mortality, Stroke/mortalityAbstract
Introduction: Aspiration pneumonia is a severe complication of stroke, related to higher stroke severity, functional impairment and dysphagia grade, increasing mortality rate, length of hospitalization and health costs. The study aims to analyse the relationship between aspiration pneumonia, the clinical type and severity of ischemic stroke and its consequences and outcomes.
Material and Methods: A retrospective study aanalysed 1116 patients admitted to a Portuguese stroke unit between 2017 and 2019, selecting and characterizing ischemic strokes according to Bamford Stroke Classification. The functional status was quantified with the modified-Rankin and Barthel scales, the severity of stroke was evaluated with the National Institutes of Health Stroke Scale, and the dysphagia status was accessed with the Gugging Swallowing Screen. These scales were evaluated at admission and discharge. Aspiration pneumonia was identified based on clinical, laboratory and radiologic findings.
Results: A population of 937 individuals (51.5%), and average age 75.6 years old. Prevalence of aspiration pneumonia of 19.5%. Total anterior circulation infarction with higher rate of aspiration pneumonia (74.3%). The functional status, severity of stroke, and grade of dysphagia were worse in the aspiration pneumonia group. The overall mortality rate was 11.6%, with an average length of 11.0 days of hospitalization, being statistically significant (p < 0.01) in the aspiration pneumonia group (40.4% and 13.8 days, respectively).
Discussion/Conclusion: Aspiration pneumonia is related to the severity of stroke, functional status, and grade of dysphagia, being related to higher mortality rates and longest length of stay.
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