Dysphagia in patients in acute period of ischemic stroke: What is the relationship of dysphagia with infarct localization, cognition, malnutrition, and independence level?

Abstract

Background and Objective: Swallowing and nutritional disorders can occur for many different reasons after stroke. This study aimed to evaluate dysphagia, malnutrition, and independence in patients with an acute period of ischemic stroke, and to examine the relationship between dysphagia and lesion location, cognition, malnutrition, and dependence.

Methods: Ischemic stroke patients (n: 109, mean age: 72.91 ± 11.78 year) were evaluated within the first 5 days after stroke. Standardized Mini-Mental State Examination (SMMSE), Combining pulse oximetry with a 10 milliliter (ml) Bedside Water Drinking Test (CPOBWDT), Mini Nutritional Assessment (MNA), and Barthel Index (BI) were performed.

Results: Dysphagia was detected in 57.8% of the patients; malnutrition was present in 19.27% and 55.96% were at risk of malnutrition. In patients with dysphagia, it was observed that the most common site of infarct involved the superior cortical division of the middle cerebral artery. SMME (p<0.001) and BI (p=0.001) were significantly worse in patients with dysphagia than patients without dysphagia.

Conclusion: This study showed that more than half of the ischemic stroke patients are at risk of dysphagia and malnutrition in the acute period after stroke. The localization of the infarct and a decrease in the cognitive level are among the factors that are associated with dysphagia. Dysphagia is associated with increased dependence for functional activities. Therefore, in patients with ischemic stroke, swallowing and malnutrition should be evaluated during the acute phase.