Early Screening Parameters for Dysphagia in Acute Ischemic Stroke

Area of Science:

• Neurology
• Clinical Medicine
• Public Health

Background:

• Dysphagia is a common complication following acute stroke, increasing risks of malnutrition, aspiration, and mortality.
• Early identification of dysphagia predictors is vital for timely intervention and improved patient outcomes.
• This study focuses on identifying easily assessable predictors for dysphagia in acute ischemic stroke patients.

Purpose of the Study:

• To identify early and easily assessable predictors of dysphagia in a large cohort of acute ischemic stroke patients.
• To determine the association between stroke severity and the presence of dysphagia.
• To investigate predictors of pneumonia in stroke patients.

Main Methods:

• Analysis of data from a prospective in-hospital registry of ischemic stroke patients over 3 years.
• Clinical swallowing investigations conducted within 24 hours of hospital admission.
• Step-wise multivariate logistic regression and receiver operating characteristic (ROC) analysis to identify independent predictors and optimal cut-off values.

Main Results:

• Higher National Institute of Health Stroke Scale (NIHSS) scores, male gender, and older age independently predicted dysphagia.
• An NIHSS cut-off score of 4.5 demonstrated optimal differentiation for dysphagia (sensitivity 0.77, specificity 0.77).
• Higher NIHSS scores, male gender, and older age were associated with pneumonia, with an NIHSS cut-off of 5.5 for differentiation.

Conclusions:

• Stroke severity, measured by NIHSS, is a simple and reliable predictor of dysphagia.
• Patients with NIHSS scores of 5 or higher warrant prompt referral for swallowing examinations.
• Dysphagia is confirmed as a significant predictor of pneumonia in stroke patients.