Cargando…

Natural History of Swallow Function during the Three-Month Period after Stroke

Oropharyngeal dysphagia is a prevalent complication following stroke (PS-OD), and one that is sometimes spontaneously recovered. This study describes the natural history of PS-OD between admission and three months post-stroke, and the factors associated with its prevalence and development. PS-OD was...

Descripción completa

Detalles Bibliográficos
Autores principales: Arreola, Viridiana, Vilardell, Natàlia, Ortega, Omar, Rofes, Laia, Muriana, Desiree, Palomeras, Ernest, Álvarez-Berdugo, Daniel, Clavé, Pere
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6787737/
https://www.ncbi.nlm.nih.gov/pubmed/31324004
http://dx.doi.org/10.3390/geriatrics4030042
_version_ 1783458341913100288
author Arreola, Viridiana
Vilardell, Natàlia
Ortega, Omar
Rofes, Laia
Muriana, Desiree
Palomeras, Ernest
Álvarez-Berdugo, Daniel
Clavé, Pere
author_facet Arreola, Viridiana
Vilardell, Natàlia
Ortega, Omar
Rofes, Laia
Muriana, Desiree
Palomeras, Ernest
Álvarez-Berdugo, Daniel
Clavé, Pere
author_sort Arreola, Viridiana
collection PubMed
description Oropharyngeal dysphagia is a prevalent complication following stroke (PS-OD), and one that is sometimes spontaneously recovered. This study describes the natural history of PS-OD between admission and three months post-stroke, and the factors associated with its prevalence and development. PS-OD was assessed with the volume-viscosity swallow test (V-VST) in all stroke patients on admission and at the three-month follow-up. We analyzed clinical, demographic, and neuroanatomical factors of 247 older post-stroke patients (National Institute of Health Stroke Scale (NIHSS) = 3.5 ± 3.8), comparing among those with PS-OD the ones with and without spontaneous recovery. PS-OD prevalence on admission was 39.7% (34.0% impaired safety; 30.8%, efficacy) and 41.7% (19.4% impaired safety; 39.3%, efficacy) at three months. Spontaneous swallow recovery occurred in 42.4% of patients with unsafe and in 29.9% with ineffective swallow, associated with younger age and optimal functional status. However, 26% of post-stroke patients developed new signs/symptoms of ineffective swallow related to poor functional, nutritional and health status, and institutionalization. PS-OD prevalence on admission and at the three-month follow-up was very high in the study population. PS-OD is a dynamic condition with some spontaneous recovery in patients with optimal functional status, but also new signs/symptoms can appear due to poor functionality. Regular PS-OD monitoring is needed to identify patients at risk of nutritional and respiratory complications.
format Online
Article
Text
id pubmed-6787737
institution National Center for Biotechnology Information
language English
publishDate 2019
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-67877372019-10-16 Natural History of Swallow Function during the Three-Month Period after Stroke Arreola, Viridiana Vilardell, Natàlia Ortega, Omar Rofes, Laia Muriana, Desiree Palomeras, Ernest Álvarez-Berdugo, Daniel Clavé, Pere Geriatrics (Basel) Article Oropharyngeal dysphagia is a prevalent complication following stroke (PS-OD), and one that is sometimes spontaneously recovered. This study describes the natural history of PS-OD between admission and three months post-stroke, and the factors associated with its prevalence and development. PS-OD was assessed with the volume-viscosity swallow test (V-VST) in all stroke patients on admission and at the three-month follow-up. We analyzed clinical, demographic, and neuroanatomical factors of 247 older post-stroke patients (National Institute of Health Stroke Scale (NIHSS) = 3.5 ± 3.8), comparing among those with PS-OD the ones with and without spontaneous recovery. PS-OD prevalence on admission was 39.7% (34.0% impaired safety; 30.8%, efficacy) and 41.7% (19.4% impaired safety; 39.3%, efficacy) at three months. Spontaneous swallow recovery occurred in 42.4% of patients with unsafe and in 29.9% with ineffective swallow, associated with younger age and optimal functional status. However, 26% of post-stroke patients developed new signs/symptoms of ineffective swallow related to poor functional, nutritional and health status, and institutionalization. PS-OD prevalence on admission and at the three-month follow-up was very high in the study population. PS-OD is a dynamic condition with some spontaneous recovery in patients with optimal functional status, but also new signs/symptoms can appear due to poor functionality. Regular PS-OD monitoring is needed to identify patients at risk of nutritional and respiratory complications. MDPI 2019-07-09 /pmc/articles/PMC6787737/ /pubmed/31324004 http://dx.doi.org/10.3390/geriatrics4030042 Text en © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Arreola, Viridiana
Vilardell, Natàlia
Ortega, Omar
Rofes, Laia
Muriana, Desiree
Palomeras, Ernest
Álvarez-Berdugo, Daniel
Clavé, Pere
Natural History of Swallow Function during the Three-Month Period after Stroke
title Natural History of Swallow Function during the Three-Month Period after Stroke
title_full Natural History of Swallow Function during the Three-Month Period after Stroke
title_fullStr Natural History of Swallow Function during the Three-Month Period after Stroke
title_full_unstemmed Natural History of Swallow Function during the Three-Month Period after Stroke
title_short Natural History of Swallow Function during the Three-Month Period after Stroke
title_sort natural history of swallow function during the three-month period after stroke
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6787737/
https://www.ncbi.nlm.nih.gov/pubmed/31324004
http://dx.doi.org/10.3390/geriatrics4030042
work_keys_str_mv AT arreolaviridiana naturalhistoryofswallowfunctionduringthethreemonthperiodafterstroke
AT vilardellnatalia naturalhistoryofswallowfunctionduringthethreemonthperiodafterstroke
AT ortegaomar naturalhistoryofswallowfunctionduringthethreemonthperiodafterstroke
AT rofeslaia naturalhistoryofswallowfunctionduringthethreemonthperiodafterstroke
AT murianadesiree naturalhistoryofswallowfunctionduringthethreemonthperiodafterstroke
AT palomerasernest naturalhistoryofswallowfunctionduringthethreemonthperiodafterstroke
AT alvarezberdugodaniel naturalhistoryofswallowfunctionduringthethreemonthperiodafterstroke
AT clavepere naturalhistoryofswallowfunctionduringthethreemonthperiodafterstroke