Screening for dysphagia and aspiration in acute stroke: a systematic review

Perry, Lin and Love, Claire (2001) Screening for dysphagia and aspiration in acute stroke: a systematic review. Dysphagia, 16(1), pp. 7-18. ISSN (print) 0179-051X

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Stroke is a common problem, producing a variety of neurological problems that affect eating. Dysphagia is a particular concern because of its potential for airway obstruction, malnutrition, and aspiration pneumonia. With chest infection reported in up to 32% of stroke patients, this is a major clinical issue. The following research questions are raised: (1) What are the incidence and outcomes of dysphagia and aspiration in acute stroke? (2) What screening interventions are available to detect dysphagia in patients with acute stroke and what effect have they on patient outcomes? A systematic review was carried out using methods and quality criteria of the NHS Centre for Reviews and Dissemination (1996), focusing on studies of adults with acute stroke. Data were extracted, collated, and presented descriptively. Two hundred forty-eight articles were retrieved with 26 meeting inclusion and quality criteria. Clinical dysphagia is common, associated with a range of deleterious outcomes and clearly linked to development of chest infection. Interpretation of aspiration on videofluoroscopy is not as straightforward but probably also confers additional risk. Further work is required on the relationship between aspiration and pneumonia, and pneumonia prevention. This will include exploration of the effects of screening, and the further development and validation of screening methods. While studies indicate current "best practice," in this important area of patient care further work is urgently required.

Item Type: Article
Uncontrolled Keywords: systemic review, cerebrovascular disorders, deglutition, deglutition disorders, gag reflex, natural-history, validation, videofluoroscopy, complications, cortex, water
Research Area: Other hospital based clinical subjects
Faculty, School or Research Centre: Faculty of Health and Social Care Sciences (until 2013)
Depositing User: Lucinda Lyon
Date Deposited: 22 May 2009 11:20
Last Modified: 14 Oct 2010 13:34

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