Dysphagia following Stroke

• Published in: European neurology Vol. 51; no. 3; pp. 162 - 167
• Main Authors: Paciaroni, Maurizio, Mazzotta, Giovanni, Corea, Francesco, Caso, Valeria, Venti, Michele, Milia, Paolo, Silvestrelli, Giorgio, Palmerini, Francesco, Parnetti, Lucilla, Gallai, Virgilio
• Format: Journal Article
• Language: English
• Published: Basel, Switzerland Karger 01.01.2004; S. Karger AG
• Subjects: Aged; Aged, 80 and over; Biological and medical sciences; Case-Control Studies; Deglutition Disorders - etiology; Deglutition Disorders - pathology; Disability Evaluation; Female; Fluoroscopy - methods; Follow-Up Studies; Humans; Logistic Models; Magnetic Resonance Imaging - methods; Male; Medical sciences; Middle Aged; Mortality; Neurology; Original Paper; Predictive Value of Tests; Prognosis; Prospective Studies; Retrospective Studies; Severity of Illness Index; Stroke - complications; Stroke - pathology; Time Factors; Tomography, X-Ray Computed - methods; Recurrence; Death; Stroke; Dysphagia; Outcome; Nervous system diseases; Prognosis; Esophageal disease; Cardiovascular disease; Cerebral disorder; Vascular disease; Central nervous system disease; Digestive diseases; Cerebrovascular disease
• ISSN: 0014-3022; 1421-9913
• DOI: 10.1159/000077663

Background: Dysphagia is common after stroke. We aimed to study the prognosis of dysphagia (assessed clinically) over the first 3 months after acute stroke and to determine whether specific neurovascular-anatomical sites were associated with swallowing dysfunction. Methods: We prospectively examined consecutive patients with acute first-ever stroke. The assessment of dysphagia was made using standardized clinical methods. The arterial territories involved were determined on CT/MRI. All patients were followed up for 3 months. Results: 34.7% of 406 patients had dysphagia. Dysphagia was more frequent in patients with hemorrhagic stroke (31/63 vs. 110/343; p = 0.01). In patients with ischemic stroke, the involvement of the arterial territory of the total middle cerebral artery was more frequently associated with dysphagia (28.2 vs. 2.2%; p < 0.0001). Multivariate analysis revealed that stroke mortality and disability were independently associated with dysphagia (p < 0.0001). Conclusions: The frequency of dysphagia was relatively high. Regarding anatomical-clinical correlation, the most important factor was the size rather than the location of the lesion. Dysphagia assessed clinically was a significant variable predicting death and disability at 90 days.