Clinical Outcomes And Predictors Of Poor Prognosis In Post-Stroke Dysphagia At Services Hospital Lahore: A Tertiary Care Observational Study
DOI:
https://doi.org/10.61919/jhrr.v6i3.1996Keywords:
Stroke, dysphagia, pneumonia, NIHSS, mRS, Services Hospital Lahore.Abstract
Background: Post-stroke dysphagia is a common complication of acute stroke and is associated with aspiration, pneumonia, prolonged hospitalization, disability, and mortality. Objective: To determine the frequency, clinical outcomes, and predictors of poor prognosis among acute stroke patients with dysphagia at Services Hospital Lahore. Methods: This cross-sectional observational study included 124 acute stroke patients categorized into dysphagia-positive and dysphagia-negative groups. Baseline characteristics, stroke subtype, NIHSS score, comorbidities, dysphagia screening, pneumonia, ICU admission, length of stay, discharge mRS, and mortality were analyzed. Poor functional outcome was defined as mRS ≥3 at discharge. Results: Dysphagia was present in 53 patients (42.7%). Dysphagia-positive patients had longer hospital stay than dysphagia-negative patients (7.1 ± 3.3 vs 3.8 ± 1.7 days), higher pneumonia frequency (24.5% vs 5.6%), greater poor functional outcome (62.3% vs 26.8%), and higher mortality (11.3% vs 2.8%). Dysphagia independently predicted poor outcome (OR 4.5, 95% CI 2.0–10.1; p<0.001). Pneumonia, NIHSS ≥15, hemorrhagic stroke, atrial fibrillation, previous stroke, and delayed screening were also significant predictors. Conclusion: Post-stroke dysphagia was frequent and strongly associated with adverse inpatient outcomes. Early screening and swallowing intervention may improve stroke care outcomes
Downloads
References
Benfield JK, Everton LF, Bath PM, England TJ. Accuracy and clinical utility of comprehensive dysphagia screening assessments in acute stroke: a systematic review and meta-analysis. J Clin Nurs. 2020. doi:10.1111/jocn.15192
Boaden E, Burnell J, Hives L, Dey P, Clegg A, Lyons MW, et al. Screening for aspiration risk associated with dysphagia in acute stroke. Cochrane Database Syst Rev. 2021. doi:10.1002/14651858.CD012679.pub2
D’Netto P, Rumbach A, Dunn K, Finch E. Clinical predictors of dysphagia recovery after stroke: a systematic review. Dysphagia. 2022. doi:10.1007/s00455-022-10443-3
Dziewas R, Michou E, Trapl-Grundschober M, Lal A, Arsava E, Bath P, et al. European Stroke Organisation and European Society for Swallowing Disorders guideline for the diagnosis and treatment of post-stroke dysphagia. Eur Stroke J. 2021. doi:10.1177/23969873211039721
Fairfield C, Smithard DG. Assessment and management of dysphagia in acute stroke: an initial service review of international practice. Geriatrics. 2020. doi:10.3390/geriatrics5010004
Finniss M, Myers J, Wilson JR, Wilson VC, Lewis P. Dysphagia after stroke: an unmet antibiotic stewardship opportunity. Dysphagia. 2021. doi:10.1007/s00455-021-10269-5
Jiang YL, Chi Y, Pan R, Zhang D, Huang S, Ju H, Li Y. Advancing stroke patient care: a network meta-analysis of dysphagia screening efficacy and personalization. Front Neurol. 2024. doi:10.3389/fneur.2024.1380287
Kiekens C, Tognonato C. Which screening tool should be used for identifying aspiration risk associated with dysphagia in acute stroke? A Cochrane Review summary with commentary. NeuroRehabilitation. 2022. doi:10.3233/NRE-228024
Krekeler BN, Schieve HJP, Khoury JC, Ding L, Haverbusch M, Alwell K, et al. Health factors associated with development and severity of poststroke dysphagia: an epidemiological investigation. J Am Heart Assoc. 2024. doi:10.1161/JAHA.123.033922
Labeit B, Michou E, Hamdy S, Trapl-Grundschober M, Suntrup-Krueger S, Muhle P, et al. The assessment of dysphagia after stroke: state of the art and future directions. Lancet Neurol. 2023. doi:10.1016/S1474-4422(23)00153-9
Labeit B, Muhle P, Dziewas R, Suntrup-Krueger S. Diagnostik und Therapie der Dysphagie nach einem Schlaganfall. Nervenarzt. 2023. doi:10.1007/s00115-023-01483-7
Liang J, Yin Z, Li Z, Gu H, Yang K, Xiong Y, et al. Predictors of dysphagia screening and pneumonia among patients with acute ischaemic stroke in China: findings from the Chinese Stroke Center Alliance. Stroke Vasc Neurol. 2022;7(4):294-301. doi:10.1136/svn-2020-000746
Londhe C, Agrawal A, Pednekar S, Pandey D, Khan MF. Swallowing dysfunction after acute stroke: the incidence, predictors and outcome. J Assoc Physicians India. 2023. doi:10.59556/japi.71.0301
Mancin S, Sguanci M, Reggiani F, Morenghi E, Piredda M, De Marinis MG. Dysphagia screening post-stroke: systematic review. BMJ Support Palliat Care. 2023. doi:10.1136/spcare-2022-004144
Mulyatsih E, Pandin MG. Dysphagia screening protocol for acute stroke patient: a literature review. Preprints. 2021. doi:10.20944/PREPRINTS202104.0476.V1
Park K, Kim TH, Lee SH. The Gugging Swallowing Screen in dysphagia screening for patients with stroke: a systematic review. Int J Nurs Stud. 2020. doi:10.1016/j.ijnurstu.2020.103588
Sherman V, Greco E, Martino R. The benefit of dysphagia screening in adult patients with stroke: a meta-analysis. J Am Heart Assoc. 2021;10(12). doi:10.1161/JAHA.120.018753
Song W, Wu M, Wang H, Pang R, Zhu L. Prevalence, risk factors, and outcomes of dysphagia after stroke: a systematic review and meta-analysis. Front Neurol. 2024. doi:10.3389/fneur.2024.1403610
Speyer R, Cordier R, Farneti D, Nascimento W, Pilz W, Vérin E, et al. White paper by the European Society for Swallowing Disorders: screening and non-instrumental assessment for dysphagia in adults. Dysphagia. 2021. doi:10.1007/s00455-021-10283-7
Yang S, Choo YJ, Chang MC. The preventive effect of dysphagia screening on pneumonia in acute stroke patients: a systematic review and meta-analysis. Healthcare. 2021;9(12):1764. doi:10.3390/healthcare9121764
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Irtaza Rubab
This work is licensed under a Creative Commons Attribution 4.0 International License.
Public Licensing Terms
This work is licensed under the Creative Commons Attribution 4.0 International License (CC BY 4.0). Under this license:
- You are free to share (copy and redistribute the material in any medium or format) and adapt (remix, transform, and build upon the material) for any purpose, including commercial use.
- Attribution must be given to the original author(s) and source in a manner that is reasonable and does not imply endorsement. If changes were made to the material, this must be indicated.
- No additional restrictions may be applied that conflict with the terms of this license.
For more details, visit: https://creativecommons.org/licenses/by/4.0/
