Ming-Chu Feng1, Yi-Ching Lin2, Yu-Han Chang3, Chun-Hung Chen4, Hsiu-Chu Chiang5, Ling-Chun Huang6, Yuan-Han Yang7, Chih-Hsing Hung8. 1. Department of Nursing, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan; School of Nursing, Fooyin University, Kaohsiung, Taiwan. 2. Department of Laboratory Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Laboratory Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Pediatrics, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan. 3. Teaching and Research Center of Kaohsiung Municipal Siaogang Hospital, Kaohsiung, Taiwan. 4. Department of Neurology, Kaohsiung Municipal Siaogang Hospital, Kaohsiung, Taiwan. 5. Department of Nursing, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan. 6. Department of Neurology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan; Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung Taiwan. 7. Department of Neurology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan; Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung Taiwan; Department of Master's Program in Neurology, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan. 8. Department of Pediatrics, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Pediatrics, Faculty of Pediatrics, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Pediatrics, Kaohsiung Municipal Siaogang Hospital, Kaohsiung, Taiwan; Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan. Electronic address: pedhung@gmail.com.
Abstract
BACKGROUND: Dysphagia may result in poor outcomes in stroke patients due to aspiration pneumonia and malnutrition. GOAL: The aim of the study was to investigate aspiration pneumonia and the mortality rate in stroke patients with dysphagia in Taiwan. METHODS: We selected 1220 stroke patients, divided them into dysphagia and nondysphagia groups, and matched them according to age; covariates and comediations from 2000 to 2005 were identified from the NHIRD 2000 database. The date of the diagnosed stroke for each patient was defined as the index date. All patients were tracked for 5 years following their index visit to evaluate mortality and the risk of aspiration pneumonia. We estimated the adjusted hazard ratio using Cox proportional hazard regression. RESULTS: Within 1 year, the dysphagia group was 4.69 times more likely to develop aspiration pneumonia than the nondysphagia group (adjusted hazard ratio [aHR], 4.69; 95% confidence interval [CI] 2.83-7.77; P < .001). The highest significant risk of aspiration pneumonia was in the cerebral hemorrhage patients within 3 years of the index visit (aHR, 5.04; 95% CI 1.45-17.49; P = .011). The 5-year mortality rate in the dysphagia group was significantly higher than that in the nondysphagia group (aHR, 1.84; 95% CI 1.57-2.16; P < .001). CONCLUSION: Dysphagia is a critical factor in aspiration pneumonia and mortality in stroke patients. Early detection and intervention of dysphagia in stroke patients may reduce the possibility of aspiration pneumonia.
BACKGROUND:Dysphagia may result in poor outcomes in strokepatients due to aspiration pneumonia and malnutrition. GOAL: The aim of the study was to investigate aspiration pneumonia and the mortality rate in strokepatients with dysphagia in Taiwan. METHODS: We selected 1220 strokepatients, divided them into dysphagia and nondysphagia groups, and matched them according to age; covariates and comediations from 2000 to 2005 were identified from the NHIRD 2000 database. The date of the diagnosed stroke for each patient was defined as the index date. All patients were tracked for 5 years following their index visit to evaluate mortality and the risk of aspiration pneumonia. We estimated the adjusted hazard ratio using Cox proportional hazard regression. RESULTS: Within 1 year, the dysphagia group was 4.69 times more likely to develop aspiration pneumonia than the nondysphagia group (adjusted hazard ratio [aHR], 4.69; 95% confidence interval [CI] 2.83-7.77; P < .001). The highest significant risk of aspiration pneumonia was in the cerebral hemorrhagepatients within 3 years of the index visit (aHR, 5.04; 95% CI 1.45-17.49; P = .011). The 5-year mortality rate in the dysphagia group was significantly higher than that in the nondysphagia group (aHR, 1.84; 95% CI 1.57-2.16; P < .001). CONCLUSION:Dysphagia is a critical factor in aspiration pneumonia and mortality in strokepatients. Early detection and intervention of dysphagia in strokepatients may reduce the possibility of aspiration pneumonia.
Authors: Morgan L Prust; Aparna Nutakki; Gloria Habanyama; Lorraine Chishimba; Mashina Chomba; Moses Mataa; Kunda Yumbe; Stanley Zimba; Rebecca F Gottesman; Mona N Bahouth; Deanna R Saylor Journal: Neurol Clin Pract Date: 2021-12
Authors: Linda Zhang; Scott Kamen; Jennifer Niles; Jessica Goss; Mark E Heslin; Nicholas Vigilante; Lauren Thau; Christopher Edwards; Kyle R Marden; Jesse M Thon; Terri Yeager; James E Siegler Journal: Neurohospitalist Date: 2022-05-06