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Aspiration in acute stroke: a clinical study with videofluoroscopy
The Quarterly Journal of Medicine
|December 1, 1993
Summary
Lung aspiration is common in acute stroke patients, affecting 42%. Reduced pharyngeal sensation and stroke severity are key risk factors for aspiration, even without obvious dysphagia.
Area of Science:
- Neurology
- Gastroenterology
- Clinical Medicine
Background:
- Acute stroke can lead to complications like lung aspiration.
- Dysphagia (difficulty swallowing) is a known risk factor for aspiration.
- Early identification of aspiration risk is crucial for patient management.
Purpose of the Study:
- To determine the incidence of lung aspiration in patients with acute stroke.
- To identify clinical factors associated with aspiration risk in these patients.
Main Methods:
- Prospective study of consecutive patients admitted within 24 hours of first symptomatic stroke.
- Clinical assessment, bedside water-swallowing test, and videofluoroscopy within 72 hours.
- Inclusion criteria: conscious patients without pre-existing dysphagia.
Main Results:
- 42% of patients (25 out of 60) were observed to aspirate via videofluoroscopy.
- 20% of aspirating patients did not show overt dysphagia on a simple water-swallowing test.
- Reduced pharyngeal sensation, dysphagia, and stroke severity were significantly associated with aspiration.
Conclusions:
- Lung aspiration is a frequent early complication of acute stroke.
- Disordered pharyngeal sensation is a significant, often undetected, factor in stroke-related aspiration.
- Careful pharyngeal sensation testing is recommended for all acute stroke admissions.