Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 May 3;11(5):e0154608.
doi: 10.1371/journal.pone.0154608. eCollection 2016.

The Multidisciplinary Swallowing Team Approach Decreases Pneumonia Onset in Acute Stroke Patients

Shiro Aoki  1 , Naohisa Hosomi  1 , Junko Hirayama  2 , Masahiro Nakamori  1 , Mineka Yoshikawa  3 , Tomohisa Nezu  1 , Satoshi Kubo  1 , Yuka Nagano  4 , Akiko Nagao  5 , Naoya Yamane  4 , Yuichi Nishikawa  4 , Megumi Takamoto  6 , Hiroki Ueno  1 , Kazuhide Ochi  1 , Hirofumi Maruyama  1 , Hiromi Yamamoto  2 , Masayasu Matsumoto  1 ; Hiroshima University Hospital Stroke Swallowing Team
Affiliations

The Multidisciplinary Swallowing Team Approach Decreases Pneumonia Onset in Acute Stroke Patients

Shiro Aoki et al. PLoS One. .

Expression of concern in

Abstract

Dysphagia occurs in acute stroke patients at high rates, and many of them develop aspiration pneumonia. Team approaches with the cooperation of various professionals have the power to improve the quality of medical care, utilizing the specialized knowledge and skills of each professional. In our hospital, a multidisciplinary participatory swallowing team was organized. The aim of this study was to clarify the influence of a team approach on dysphagia by comparing the rates of pneumonia in acute stroke patients prior to and post team organization. All consecutive acute stroke patients who were admitted to our hospital between April 2009 and March 2014 were registered. We analyzed the difference in the rate of pneumonia onset between the periods before team organization (prior period) and after team organization (post period). Univariate and multivariate analyses were performed using a Cox proportional hazards model to determine the predictors of pneumonia. We recruited 132 acute stroke patients from the prior period and 173 patients from the post period. Pneumonia onset was less frequent in the post period compared with the prior period (6.9% vs. 15.9%, respectively; p = 0.01). Based on a multivariate analysis using a Cox proportional hazards model, it was determined that a swallowing team approach was related to pneumonia onset independent from the National Institutes of Health Stroke Scale score on admission (adjusted hazard ratio 0.41, 95% confidence interval 0.19-0.84, p = 0.02). The multidisciplinary participatory swallowing team effectively decreased the pneumonia onset in acute stroke patients.

PubMed Disclaimer

Conflict of interest statement

Competing Interests: NH reports honoraria from Mochida Pharmaceutical Co., LTD. outside the scope of the submitted work. Prof. Matsumoto reports grants from Mochida Pharmaceutical Co., LTD., Otsuka Pharmaceutical, and Daiichi Sankyo Co., LTD. as well as honoraria from Sanofi K.K., Bayer Health Care, Otsuka Pharmaceutical, Daiichi Sankyo Co., LTD., Boehringer Ingelheim, and Sumitomo Dainippon Pharma Co., LTD., that are outside the scope of the submitted work. Other authors have declared that no competing interests exist. This does not alter our adherence to PLOS ONE policies on sharing data and materials.

Figures

Fig 1
Fig 1. Probability of not developing pneumonia in the prior period and in the post period.
Pneumonia onset was less frequent in the post period compared with the prior period.
See this image and copyright information in PMC

References

    1. Gordon C, Hewer RL, Wade DT. Dysphagia in acute stoke. Br Med J. 1987; 295: 411–414. - PMC - PubMed
    1. Smithard DG, O'Neill PA, England RE, Park CL, Wyatt R, Martin DF, et al. The natural history of dysphagia following a stroke. Dysphagia. 1997; 12: 188–193. - PubMed
    1. Johnston KC, Li JY, Lyden PD, Hanson SK, Feasby TE, Adams RJ, et al. Medical and neurological complications of ischemic stroke: experience from the RANTTAS Trial. Stroke. 1998; 29: 447–453. - PubMed
    1. Langhorne P, Stott DJ, Robertson L, MacDonald J, Jones L, McAlpine C, et al. Medical complications after stroke: a multicenter study. Stroke. 2000; 31: 1223–1229. - PubMed
    1. Katzan IL, Cebul RD, Husak SH, Dawson NV, Baker DW. The effect of pneumonia on mortality among patients hospitalized for acute stroke. Neurology. 2003; 60: 620–625. - PubMed

Publication types