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Cough reflex testing in Dysphagia following stroke: a randomized controlled trial
Anna Miles1, Irene S L Zeng, Helen McLauchlan
1Department of Communication Disorders, The University of Canterbury, 66 Stewart St, Christchurch 8011, New Zealand ; Speech Science, School of Psychology, The University of Auckland, Private Bag 92019, Auckland 1142, New Zealand.
Cough reflex testing (CRT) did not reduce pneumonia rates in acute stroke patients with dysphagia. While CRT influenced clinical decisions, it did not achieve the primary goal of lowering pneumonia incidence.
Area of Science:
- Neurology
- Pulmonology
- Gastroenterology
Background:
- Post-stroke pneumonia is a significant health concern linked to dysphagia.
- Silent aspiration increases pneumonia and mortality risk in stroke survivors.
- Effective interventions are needed to manage dysphagia-related complications.
Purpose of the Study:
- To evaluate the efficacy of cough reflex testing (CRT) in reducing pneumonia rates among acute stroke patients with dysphagia.
- To assess the impact of CRT on clinical management and patient outcomes.
Main Methods:
- A randomized controlled trial involving 311 patients referred for swallowing evaluation.
- Participants were assigned to either standard evaluation (control) or standard evaluation plus CRT (experimental).
- Outcomes included pneumonia rates at 3 months, mortality, diet recommendations, and instrumental assessment referrals.
Main Results:
- No significant difference in pneumonia rates (P = 0.38) or mortality (P = 0.15) between the CRT and control groups.
- CRT significantly influenced diet recommendations (P < 0.0001) and referrals for instrumental assessment (P < 0.0001).
Conclusions:
- Cough reflex testing did not achieve the primary goal of reducing pneumonia in post-stroke dysphagia patients.
- Despite altering clinical management, CRT's utility in preventing pneumonia requires further investigation.
