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Dysphagia is a strong pbkp_redictor of death and functional dependence at three months post-stroke

Abstract:

Background:FewBrazilianstudiesinvestigatedriskfactorsfordysphagiaandassociatedcomplicationsinalargecohort.Objective:Toinvestigate frequency, pbkp_redictors, 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 pbkp_redictors of dysphagia, which was independently associated with death or functional dependence at three months.