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
Randomized Controlled Trial
. 2025 Jun;10(2):568-575.
doi: 10.1177/23969873241284123. Epub 2024 Oct 10.

Intensified post-stroke care improves long-term dysphagia recovery after acute ischemic stroke: Results from the STROKE CARD trial

Anel Karisik  1   2 , Vincent Bader  1 , Kurt Moelgg  1   2 , Lucie Buergi  1   2 , Benjamin Dejakum  1 , Silvia Komarek  1 , Christian Boehme  1 , Thomas Toell  1 , Lukas Mayer-Suess  1 , Simon Sollereder  2 , Sonja Rossi  3 , Patricia Meier  2 , Gudrun Schoenherr  1 , Johann Willeit  1 , Peter Willeit  4   5 , Wilfried Lang  2   6 , Stefan Kiechl  1   2 , Michael Knoflach  1   2 , Raimund Pechlaner  1
Affiliations
Randomized Controlled Trial

Intensified post-stroke care improves long-term dysphagia recovery after acute ischemic stroke: Results from the STROKE CARD trial

Anel Karisik et al. Eur Stroke J. 2025 Jun.

Abstract

Introduction: Dysphagia is common after acute ischemic stroke and entails considerable morbidity and mortality. Here, we investigated the impact of intensified care on swallowing recovery after stroke.

Patients and methods: In this secondary analysis of STROKE-CARD, a randomized intervention trial of intensified post-stroke care, dysphagia was assessed by speech therapists at admission for acute ischemic stroke, at hospital discharge, and after 12-months. Patients randomized to STROKE-CARD care additionally received a detailed dysphagia follow-up at 3-months, including a standardized dysphagia examination, instructions on further exercises and compensation mechanisms and, if necessary, referral for further speech therapy.

Results: Dysphagia was present initially after stroke in 236 (16.6%; median age 82 (73-88), 44.1% female) of 1419 patients, with similar prevalence in both study groups at hospital admission (p = 0.239) and discharge (p = 0.870). At follow up, 14 (9.5%) of 147 in the intervention group and 18 (20.2%) of 89 in the control group suffered from persistent dysphagia (p = 0.020). There was better dysphagia recovery in the intervention group also under multivariable adjustment for age, sex, functional disability at 12-months, severe dysphagia at hospitalization, mode of feeding, cognitive impairment, thrombolysis, and stroke localization (odds ratio, 0.41, 95% confidence interval: 0.17 to 0.96).

Discussion and conclusion: Intensified post-stroke care improved dysphagia recovery within 1 year after acute ischemic stroke, highlighting the potential of targeted interventions for enhancing stroke outcomes.

Keywords: Dysphagia; intensified care; ischemic stroke; recovery.

PubMed Disclaimer

Conflict of interest statement

Declaration of conflicting interestThe author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: PW reports consultancy fees from Novartis Pharmaceuticals unrelated to this manuscript. The remaining authors report no disclosures relevant to this research.

Figures

Graphical abstract
Graphical abstract
Figure 1.
Figure 1.
Study flow chart.
See this image and copyright information in PMC

References

    1. Cohen DL, Roffe C, Beavan J, et al. Post-stroke dysphagia: a review and design considerations for future trials. Int J Stroke 2016; 11: 399–411. - PubMed
    1. Arnold M, Liesirova K, Broeg-Morvay A, et al. Dysphagia in acute stroke: incidence, burden and impact on clinical outcome. PLoS One 2016; 11: e0148424. - PMC - PubMed
    1. Galovic M, Stauber AJ, Leisi N, et al. Development and validation of a prognostic model of swallowing recovery and enteral tube feeding after ischemic stroke. JAMA Neurol 2019; 76: 561–570. - PMC - PubMed
    1. Mann G, Hankey GJ, Cameron D. Swallowing function after stroke: prognosis and prognostic factors at 6 months. Stroke 1999; 30: 744–748. - PubMed
    1. Smithard DG, O’Neill PA, England RE, et al. The natural history of dysphagia following a stroke. Dysphagia 1997; 12: 188–193. - PubMed

Publication types

LinkOut - more resources