Aspiration in patients with acute stroke

Area of Science:

• Neurology
• Swallowing Disorders
• Clinical Diagnostics

Background:

• Aspiration is a significant complication following acute stroke.
• Early identification of aspiration risk is crucial for patient management.
• Clinical examination findings may predict aspiration in stroke patients.

Purpose of the Study:

• To determine the incidence of aspiration within five days of acute stroke.
• To identify clinical predictors of aspiration, including silent aspiration.
• To evaluate the accuracy of clinical findings in predicting aspiration.

Main Methods:

• A case series design was employed at a tertiary care center.
• Fifty-five consecutive stroke patients with new neurologic deficits were evaluated.
• Clinical swallowing and oromotor examinations were compared with videofluoroscopic swallow study (VSS) findings for aspiration.

Main Results:

• Aspiration occurred in 38% (21/55) of patients.
• Silent aspiration was identified in 67% (14/21) of patients who aspirated.
• Dysphonia, dysarthria, abnormal gag reflex, abnormal volitional cough, and cough after swallow were significant predictors of aspiration.

Conclusions:

• Silent aspiration is a prevalent issue in acute stroke, affecting a majority of aspirating patients.
• Concurrent abnormal volitional cough and cough with swallow significantly improve the prediction of aspiration risk.
• Clinical examination holds value in identifying stroke patients at risk for aspiration.