This Article  • References  • Full text PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (107)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Social Bookmarking   What's this?

Marlene A. Holas, MS; Kathleen L. DePippo, MS; Michael J. Reding, MD

Arch Neurol. 1994;51(10):1051-1053.

Abstract
Objective
To determine the relative risk of pneumonia, dehydration, and death associated with videofluoroscopic evidence of aspiration, silent aspiration, aspiration of 10% or greater on one or more barium test swallows, and aspiration of thick liquid or more solid consistencies in the subacute phase after stroke.

Design
Prospective, longitudinal cohort study.

Setting
Inpatient stroke rehabilitation unit.

Patients
There were 114 consecutive patients who met the following criteria: (1) stroke as defined by clinical history and neurological examination with compatible computed tomographic or magnetic resonance imaging scan; (2) age 20 to 90 years, inclusive; (3) no known history of significant oropharyngeal anomaly; and (4) videofluoroscopic evidence of dysphagia. Of 122 eligible patients, eight refused participation.

Main Outcome Measures
Development of pneumonia, dehydration, and death.

Results
The relative risk for developing pneumonia was 6.95 times greater (P=.027) for those patients who aspirated comparedwith those who did not, 5.57 times greater (P=.012) for those who aspirated silently compared with those who coughed when aspirating or who did not aspirate, and 8.36 times greater (P=.002) for those who aspirated 10% or greater on one or more barium test swallows compared with those who aspirated less than 10% or did not aspirate.

Conclusion
Aspiration, silent aspiration, and aspiration of 10% or greater on one or more barium test swallows during videofluoroscopic evaluation are associated with an increased risk of pneumonia, but not dehydration or death, during the subacute phase after stroke.

Author Affiliations
From the Cornell University Medical College at the Burke Rehabilitation Hospital, White Plains, NY.

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Aspiration Pneumonitis and Aspiration Pneumonia
Cavallazzi et al.
Swallowing and Swallowing Disorders (Dysphagia) 2009;18:25-33.
ABSTRACT | FULL TEXT  

The Safety of Fiberoptic Endoscopic Evaluation of Swallowing in Acute Stroke Patients
Warnecke et al.
Stroke 2009;40:482-486.
ABSTRACT | FULL TEXT  

Infection After Acute Ischemic Stroke: A Manifestation of Brain-Induced Immunodepression
Chamorro et al.
Stroke 2007;38:1097-1103.
ABSTRACT | FULL TEXT  

Dysphagia in stroke patients.
Singh and Hamdy
Postgrad. Med. J. 2006;82:383-391.
ABSTRACT | FULL TEXT  

Improving care for patients with dysphagia
Rosenvinge and Starke
Age Ageing 2005;34:587-593.
ABSTRACT | FULL TEXT  

Effects of an Angiotensin-converting Enzyme Inhibitor-based Regimen on Pneumonia Risk
Ohkubo et al.
Am. J. Respir. Crit. Care Med. 2004;169:1041-1045.
ABSTRACT | FULL TEXT  

Placing nasogastric tubes in stroke patients with dysphagia: efficiency and tolerability of the reflex placement
Dziewas et al.
J. Neurol. Neurosurg. Psychiatry 2003;74:1429-1431.
ABSTRACT | FULL TEXT  

Aspiration Pneumonia and Dysphagia in the Elderly
Marik and Kaplan
Chest 2003;124:328-336.
ABSTRACT | FULL TEXT  

Videofluoroscopic Studies of Swallowing Dysfunction and the Relative Risk of Pneumonia
Pikus et al.
Am. J. Roentgenol. 2003;180:1613-1616.
ABSTRACT | FULL TEXT  

Early Assessments of Dysphagia and Aspiration Risk in Acute Stroke Patients
Ramsey et al.
Stroke 2003;34:1252-1257.
ABSTRACT | FULL TEXT  

Prediction of Aspiration in Patients With Newly Diagnosed Untreated Advanced Head and Neck Cancer
Rosen et al.
Arch Otolaryngol Head Neck Surg 2001;127:975-979.
ABSTRACT | FULL TEXT  

Aspiration Pneumonitis and Aspiration Pneumonia
Marik
NEJM 2001;344:665-671.
FULL TEXT  

Swallowing Function After Stroke : Prognosis and Prognostic Factors at 6 Months
Mann et al.
Stroke 1999;30:744-748.
ABSTRACT | FULL TEXT  

Lower Esophageal Sphincter Dysfunction Often Precludes Safe Gastric Feeding in Stroke Patients
Lucas et al.
Arch Surg 1999;134:55-58.
ABSTRACT | FULL TEXT  

Neurogenic dysphagia: the role of the neurologist
HUGHES and WILES
J. Neurol. Neurosurg. Psychiatry 1998;64:569-572.
FULL TEXT  

Predictive value of clinical indices in detecting aspiration in patients with neurological disorders
Mari et al.
J. Neurol. Neurosurg. Psychiatry 1997;63:456-460.
ABSTRACT | FULL TEXT  

Effect of Malnutrition After Acute Stroke on Clinical Outcome
Davalos et al.
Stroke 1996;27:1028-1032.
ABSTRACT | FULL TEXT