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Tytuł:
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Delayed Swallowing Reflex is Overlooked in Swallowing Screening Among Acute Stroke Patients.
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Autorzy:
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Takeda C; Department of Advanced Prosthodontics, Hiroshima University Graduate School of Biomedical and Health Sciences, 1-2-3 Kasumi, Minami-Ku, Hiroshima 734-8553, Japan.
Yoshida M; Department of Advanced Prosthodontics, Hiroshima University Graduate School of Biomedical and Health Sciences, 1-2-3 Kasumi, Minami-Ku, Hiroshima 734-8553, Japan. Electronic address: .
Nakamori M; Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan; Department of Neurology, Chikamori Hospital, Kochi, Japan.
Hosomi N; Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan; Department of Oral and Maxillofacial Radiology, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan; Department of Health Sciences, Faculty of Human Culture and Sciences, Prefectural University of Hiroshima, Hiroshima, Japan.
Nagasaki T; Department of Oral and Maxillofacial Radiology, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan.
Yoshikawa M; Department of Advanced Prosthodontics, Hiroshima University Graduate School of Biomedical and Health Sciences, 1-2-3 Kasumi, Minami-Ku, Hiroshima 734-8553, Japan.
Kayashita J; Department of Health Sciences, Faculty of Human Culture and Sciences, Prefectural University of Hiroshima, Hiroshima, Japan.
Masuda S; Department of children Sensory, Hiroshima Prefectural Hospital, Hiroshima, Japan.
Maruyama H; Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan.
Tsuga K; Department of Advanced Prosthodontics, Hiroshima University Graduate School of Biomedical and Health Sciences, 1-2-3 Kasumi, Minami-Ku, Hiroshima 734-8553, Japan.
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Źródło:
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Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association [J Stroke Cerebrovasc Dis] 2020 Dec; Vol. 29 (12), pp. 105303. Date of Electronic Publication: 2020 Oct 09.
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Typ publikacji:
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Journal Article
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Język:
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English
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Imprint Name(s):
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Publication: Philadelphia, PA : Saunders
Original Publication: New York, NY : Demos Publications, [1991-
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MeSH Terms:
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Deglutition*
Point-of-Care Testing*
Reaction Time*
Reflex*
Video Recording*
Deglutition Disorders/*diagnosis
Stroke/*diagnosis
Aged ; Aged, 80 and over ; Deglutition Disorders/etiology ; Deglutition Disorders/physiopathology ; Female ; Fluoroscopy ; Humans ; Male ; Middle Aged ; Pneumonia, Aspiration/etiology ; Predictive Value of Tests ; Prospective Studies ; Stroke/complications ; Stroke/physiopathology ; Time Factors
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Contributed Indexing:
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Keywords: Acute; Aspiration; Dysphagia; Fluoroscopy; Stroke; Swallowing
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Entry Date(s):
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Date Created: 20201011 Date Completed: 20201208 Latest Revision: 20201214
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Update Code:
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20240105
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DOI:
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10.1016/j.jstrokecerebrovasdis.2020.105303
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PMID:
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33039771
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Background and Purpose: Dysphagia in the acute phase of stroke contributes significantly to poor outcomes and is associated with the development of aspiration pneumonia and malnutrition. Therefore, an accurate evaluation of swallowing is necessary before initiating oral food intake. The modified water swallow test (MWST) and the repetitive saliva swallow test (RSST) are commonly used as bedside screening methods for swallowing dysfunction, but it is unclear whether other factors contribute to dysphagia and consequent aspiration. The purpose of this study was to identify characteristics that might be overlooked in screening tests.
Methods: Participants were prospectively selected from patients hospitalized for stroke at the Suiseikai Kajikawa Hospital between August 1, 2016 and June 30, 2018. Inclusion criteria were conscious and stable medical condition, and patients who were diagnosed with dementia were excluded. A videofluoroscopic (VF) swallowing study was carried out on all patients who met the inclusion/exclusion criteria and who passed both the MWST and the RSST.
Results: Aspiration was observed in 16 of 172 patients (9.3%) when swallowing 3 ml of water. These aspirated patients showed significantly delayed swallowing reflex on VF.
Conclusions: Swallowing evaluation using a combination of the MWST and the RSST is reasonably effective. However, patients who show a delayed swallowing reflex might be overlooked by this screening procedure.
Competing Interests: Declaration of Competing Interest H. Maruyama obtained speaker fees from Eisai, Pfizer, Takeda Pharmaceutical, Otsuka Pharmaceutical, Nihon Pharmaceutical, Teijin Pharma, Fuji Film, Boehringer Ingelheim, Sumitomo Dainippon Pharma, Nihon Medi-Physics, Bayer, MSD, Daiichi Sankyo, Kyowa Hakko Kirin, Sanofi, Novartis, Kowa Pharmaceutical, Astellas Pharma, Japan Blood Products Organization, Mitsubishi Tanabe Pharma, Ono pharmaceutical, Biogen, and Bristol-Myers Squibb, and research support from Eisai, Pfizer, Takeda Pharmaceutical, Otsuka Pharmaceutical, Nihon Pharmaceutical, Shionogi, Teijin Pharma, Fuji Film, Boehringer Ingelheim, Sumitomo Dainippon Pharma, Nihon Medi-Physics, Bayer, MSD, Daiichi Sankyo, Kyowa Hakko Kirin, Sanofi, Novartis, Kowa Pharmaceutical, Astellas Pharma, Tsumura, Japan Blood Products Organization, Mitsubishi Tanabe Pharma, Mylan.
(Copyright © 2020 Elsevier Inc. All rights reserved.)
