Abstract
Dysphagia increases the risk of pneumonia in stroke patients. This study aimed to
evaluate bedside swallowing screening for prevention of stroke-associated pneumonia
(SAP) in acute stroke patients admitted to the intensive care unit (ICU). Consecutive
acute stroke patients admitted to the stroke ICU from May 2006 to March 2007 were
included. Patients were excluded if they were intubated on the first day of admission
or had a transient ischemic attack. A 3-Step Swallowing Screen was introduced since
October 2006 and therefore patients were divided into pre-screen and post-screen groups.
A binary logistic regression model was used to determine independent risk factors
for SAP and in-hospital death. There were 74 and 102 patients included in the pre-
and post-screen groups, respectively. Pneumonia was associated with higher National
Institutes of Health Stroke Scale (NIHSS) score, older age, nasogastric and endotracheal
tube placement. After adjusting for age, gender, NIHSS score and nasogastric and endotracheal
tube insertion, dysphagia screening was associated with a borderline decrease in SAP
in all stroke patients (odds ratio, 0.42; 95% CI, 0.18–1.00; p=0.05). However, dysphagia screening was not associated with reduction of in-hospital
deaths. Systematic bedside swallowing screening is helpful for prevention of SAP in
acute stroke patients admitted to the ICU.
Keywords
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Article info
Publication history
Published online: May 06, 2011
Accepted:
April 1,
2011
Received in revised form:
March 30,
2011
Received:
January 30,
2011
Identification
Copyright
© 2011 Elsevier B.V. Published by Elsevier Inc. All rights reserved.
