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. 2025 Jan 1;73(1):110-116.
doi: 10.4103/ni.ni_972_21. Epub 2025 Feb 7.

Incidence, Risk Factors, and Complications of Dysphagia in Stroke Patients Admitted to Medical Wards at a Tertiary Hospital in South India

Dvs Kiran Kumar  1 , Asisha Mathensingh  1 , Muruga Bharathy Kalimuthu  1 , Philip George  2 , Ronald Carey Albert Benton  1 , Raji Thomas  3 , Rajiv Micheal  4 , Suma Susan Mathew  2 , Sanjith Aaron  5 , Shipra Bedford  2 , Swapna Santhosh  2 , Veena Helen Mary  3 , P Bindu Synthia  3 , Jeyaseelan Visalakshi  6 , Ajay Kumar Mishra  1 , Thambu David Sudarsanam  1
Affiliations

Incidence, Risk Factors, and Complications of Dysphagia in Stroke Patients Admitted to Medical Wards at a Tertiary Hospital in South India

Dvs Kiran Kumar et al. Neurol India. .

Abstract

Background: Stroke patients commonly have dysphagia that can lead to aspiration pneumonia and, in some cases, death. The risk factors for poor outcomes have not been described well in a South Indian population.

Objective: We aimed to assess the incidence of dysphagia and subsequent pneumonia and mortality in a cohort of stroke patients.

Materials and methods: We screened 472 consecutive stroke patients, among whom 100 were included. Each patient was assessed by the clinician, speech therapist, and ENT surgeon. We calculated the stroke scores - National Institute of Health Stroke Score (NIHSS), modified Rankin score - as well as the swallowing scores, that is, Mann's and Functional Oral Intake Scale (FOIS) score, and performed video laryngoscopy. We evaluated dysphagia, aspiration pneumonia, removal of nasogastric tube, and death for up to 3 months after the diagnosis.

Results: Of 100 stroke patients, we found that 77 had dysphagia. Twenty-seven (35%) developed pneumonia; 16/27 (59.3%) died within 3 months of ictus. Among the 48 who did not develop pneumonia, six died (12.5%). Compared to a consensus definition of dysphagia, Mann's score less than 177 rules in dysphagia, while a score more than 187 rules out dysphagia. Higher NIHSS score and weak gag reflex were the independent factors for dysphagia. Most patients with dysphagia improved. Dysphagia is significantly associated with pneumonia (35%) and high mortality (20.8%).

Conclusions: Dysphagia was seen in 77% of our stroke patients; 28% developed pneumonia. In 3 months, majority recovered from dysphagia. Higher NIHSS scores and a weak gag were independent predictors of dysphagia. Also, 35% with dysphagia developed pneumonia, among whom the mortality was 59.3%.

Keywords: Cohort; dysphagia; mortality; pneumonia; stroke.

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References

    1. cvd_atlas_15_burden_stroke.pdf. Availablefrom: https://www.who.int/cardiovascular_diseases/en/cvd_atlas_15_burden_strok.... [Last accessed on 2021 Jul 19].
    1. Johnson CO, Nguyen M, Roth GA, Nichols E, Alam T, Abate D, et al. Global, regional, and national burden of stroke, 1990–2016: A systematic analysis for the Global Burden of Disease Study 2016. Lancet Neurol 2019;18:439–58.
    1. Singh G, Sharma M, Kumar GA, Rao NG, Prasad K, Mathur P, et al. The burden of neurological disorders across the states of India: The Global Burden of Disease Study 1990–2019. Lancet Glob Health 2021;9:e1129-44.
    1. Feigin VL, Lawes CM, Bennett DA, Anderson CS. Stroke epidemiology: A review of population-based studies of incidence, prevalence, and case-fatality in the late 20th century. Lancet Neurol 2003;2:43–53.
    1. Silver FL, Norris JW, Lewis AJ, Hachinski VC. Early mortality following stroke: A prospective review. Stroke 1984;15:492–6.

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