Initial clinical and demographic predictors of swallowing impairment following acute stroke

Giselle Mann, Graeme J. Hankey

Research output: Contribution to journalArticlepeer-review

91 Scopus citations

Abstract

Swallowing impairment (dysphagia) is a frequent sequela of acute stroke; however, the ability to accurately detect dysphagia at the bedside and predict which patients may be at risk of dysphagic complications, such as aspiration, remains limited. Despite this, clinical assessment batteries continue to be the first point of assessment for acute dysphagia. We examined the predictive value of clinical factors suggestive of swallowing dysfunction in an attempt to identify the important independent clinical signs at initial presentation that are associated with dysphagia, aspiration, and the combined variable aspiration and/or penetration (ASPEN) in acute stroke patients. For the purposes of this study, dysphagia was defined as a disorder of bolus flow. Aspiration was defined as entry of swallowed material below the level of the true vocal cords which was not expectorated. The clinical items identified as independent predictors of dysphagia (measured radiographically) at initial presentation were age > 70 years, male gender, disabling stroke (Barthel score < 60), palatal weakness or asymmetry, incomplete oral clearance, and impaired pharyngeal response (cough/gurgle). The clinical predictors of aspiration (determined radiographically) at initial presentation were delayed oral transit and incomplete oral clearance. Incorporating clinical signs, such as those identified by this study, into clinical assessments of swallowing impairment may increase their predictive utility.

Original languageEnglish (US)
Pages (from-to)208-215
Number of pages8
JournalDysphagia
Volume16
Issue number3
DOIs
StatePublished - 2001
Externally publishedYes

Keywords

  • Aspiration
  • Deglutition
  • Deglutition disorders
  • Predictors
  • Stroke
  • Swallowing impairment

ASJC Scopus subject areas

  • Otorhinolaryngology
  • Gastroenterology
  • Speech and Hearing

Fingerprint

Dive into the research topics of 'Initial clinical and demographic predictors of swallowing impairment following acute stroke'. Together they form a unique fingerprint.

Cite this