Profile of dysphagia in acute stroke: a prospective observational study from a tertiary care centre in Mumbai, India

Abstract

Background and Objectives: Acute stroke is a leading cause of morbidity and mortality all around the world. Poststroke dysphagia is an important yet under-recognised complication occurring in the post-stroke period that may result in undernutrition, dehydration, aspiration pneumonitis, and retard the recovery of the patient. Despite the many path-breaking research in the management of stroke in the present era, post-stroke dysphagia remains a neglected area of research. Materials and methods: In the current study, consecutive patients of acute stroke who fulfilled inclusion criteria during hospitalization were evaluated for swallowing functions using a validated scale with varying consistencies of food at the time of admission and discharge. We analysed different parameters to evaluate swallowing functions following an acute stroke; incidence of post-stroke dysphagia, association between stroke severity and dysphagia and lastly impact of the dysphagia on duration of hospital stay and healthcare expenditure. Results: In our study, the incidence of dysphagia was 35% amongst all categories of acute stroke and stroke severity at admission was a strong predictor for risk of post-stroke dysphagia. Patients with dysphagia had higher average NIHSS scores as compared to patients without dysphagia. Despite the high incidence of dysphagia, most of the patients recovered significantly at the time of discharge. Post-stroke dysphagia was associated with extended duration of hospital stay and increased cost of healthcare as compared to patients without dysphagia. Conclusion: Dysphagia is a common complication occurring in patients with acute stroke and is seen in patients with increasing severity of stroke. Adequate screening of dysphagia and its management can help reduce complications, reduce hospital stay and the economic burden to the patient.