NDLI: Dysphagia is a strong predictor of death and functional dependence at three months post-stroke

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Author	Aline Cristina PACHECO-CASTILHO Rubia Poliana Crisóstomo MIRANDA Ana Maria Queirós NORBERTO Diandra Bosi FAVORETTO Brunna Pileggi RIMOLI Luciana Bezerra de Mello ALVES Karina Tavares WEBER Taiza Elaine Grespan SANTOS Julio Cesar MORIGUTI João Pereira LEITE Roberto Oliveira DANTAS Rosemary MARTINO Octávio Marques PONTES-NETO
Abstract	ABSTRACT Background: Few Brazilian studies investigated risk factors for dysphagia and associated complications in a large cohort. Objective: To investigate frequency, predictors, and associated outcomes of dysphagia in patients up to three months post-stroke. Methods: Prospective cohort study of consecutively admitted patients in a specialized center for acute stroke. Patients with a transient ischemic attack, subarachnoid hemorrhage, cerebral venous thrombosis, hemorrhagic stroke with secondary cause, non-acute stroke, or those who did not consent to participate were excluded. Swallowing was evaluated by speech language pathologists using Volume-Viscosity Swallow Test. General function at three months post-stroke was assessed using the following instruments: Modified Rankin scale, Barthel Index and Functional Independence Measure. Results: A total of 831 patients were admitted and 305 patients were included according to the inclusion and exclusion criteria. The mean age of patients was 63.6±13.3 years, mean time from stroke to swallowing assessment was 4.2±4.1 days, and 45.2% of the patients had dysphagia. Age (OR=1.02; 95%CI 1.00-1.04; p=0.017), known medical history of obstructive sleep apnea (OR=5.13; 95%CI 1.74-15.15; p=0.003), and stroke severity at hospital admission (OR=1.10; 95%CI 1.06-1.15; p<0.001) were independently associated with dysphagia. Dysphagia (OR=3.78; 95%CI 2.16-6.61; p<0.001) and stroke severity (OR=1.05; 95%CI 1.00-1.09; p=0.024) were independently associated with death or functional dependence at three months. Conclusions: Dysphagia was present in almost half of stroke patients. Age, obstructive sleep apnea, and stroke severity were predictors of dysphagia, which was independently associated with death or functional dependence at three months.
ISSN	0004282X
e-ISSN	16784227
DOI	10.1590/0004-282x-anp-2021-0127
Journal	Arquivos de Neuro-Psiquiatria
Language	English
Publisher	Academia Brasileira de Neurologia (ABNEURO)
Publisher Date	2022-01-01
Publisher Place	Brazil
Access Restriction	Open
Subject Keyword	Neurosciences. Biological Psychiatry. Neuropsychiatry Deglutition Deglutition Disorders Stroke Outcome Assessment, Health Care
Content Type	Text
Resource Type	Article
Subject	Neurology Biological Psychiatry Neurology (clinical)

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