Associations between Spontaneous Swallowing Frequency at Admission, Dysphagia and Stroke Related Outcomes in Acute Care

Publication date: Available online 5 February 2019

Source: Archives of Physical Medicine and Rehabilitation

Author(s): Giselle Carnaby, Isaac Sia, Michael Crary

Abstract

Objective

To expand the scope of prior spontaneous swallowing frequency analysis (SFA) studies, by evaluating the role of SFA in dysphagia-and stroke-related outcomes at acute stroke discharge.

Design

Period prevalence study

Setting

Tertiary care university hospital

Participants

96 patients with acute stroke.

Interventions

Subjects were screened for dysphagia using SFA. Mode of screening was 24 hours from identified stroke onset. All patients completed dysphagia- and stroke-related assessments. Patients were followed to discharge from acute care and admission SFA was compared to status at discharge.

Results

Lower SFA rates at admission were significantly associated with presence of dysphagia. Lower SFA rates were also associated with persistent dysphagia and restricted diet at discharge. SFA rates were lower for patients with identified aspiration on fluoroscopic swallowing study. Negative stroke-related outcomes from acute care were associated with lower SFA rates including disability at admission, disability and handicap at discharge, and institutionalization at discharge. Regression analysis identified SFA as an independent predictor of the negative composite outcome of death-disability-institutionalization.

Conclusions

SFA not only has a high accuracy of dysphagia identification in acute stroke and relates to dysphagia severity, it is also associated with multiple dysphagia- and stoke-related outcomes from acute care. Early post-stroke dysphagia identification with SFA may lead to earlier and more effective interventions targeted at identified negative stroke outcomes.

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