Dysphagia screening after intracerebral hemorrhage

Area of Science:

• Neurology
• Stroke Medicine
• Swallowing Disorders

Background:

• Dysphagia screening is crucial post-stroke to prevent aspiration.
• Limited data exists on dysphagia screening frequency and outcomes in intracerebral hemorrhage (ICH) patients.

Purpose of the Study:

• To determine dysphagia screening rates in ICH patients.
• To identify predictors of screening and failure in ICH.
• To examine outcomes associated with failed screening in ICH.

Main Methods:

• Retrospective analysis of the Ontario Stroke Registry (2010-2013).
• Comparison of dysphagia screening rates between ICH and ischemic stroke patients.
• Assessment of predictors and outcomes related to dysphagia screening in ICH.

Main Results:

• 32.4% of ICH patients lacked documented dysphagia screening; this rose to 40% in mild ICH.
• Older age, stroke severity, speech deficits, low consciousness, and ICU admission predicted screening failure.
• Failed screening correlated with increased pneumonia, severe disability, and 1-year mortality.
• ICH patients received less screening and failed more often than ischemic stroke patients.

Conclusions:

• A significant proportion of ICH patients are not screened for dysphagia, particularly those with milder strokes.
• Screening failure in ICH is associated with adverse outcomes, including mortality.
• ICH patients require improved access to dysphagia screening within stroke care pathways.