Impact of dysphagia assessment and management on risk of stroke-associated pneumonia: A systematic review

ELTRINGHAM, Sabrina, KILNER, Karen, GEE, Melanie, SAGE, Karen, BRAY, Benjamin, POWNALL, Sue and SMITH, Craig (2018). Impact of dysphagia assessment and management on risk of stroke-associated pneumonia: A systematic review. Cerebrovascular Diseases, 46 (3-4), 97-105.

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Official URL: https://www.karger.com/Article/FullText/492730
Link to published version:: https://doi.org/10.1159/000492730

Abstract

Background Patients with dysphagia are at increased risk of stroke-associated pneumonia. There is wide variation in the way patients are screened and assessed during the acute phase. The aim of this review was to identify which methods of assessment and management in acute stroke influence the risk of stroke-associated pneumonia. Studies of stroke patients that reported dysphagia screening, assessment or management and occurrence of pneumonia during acute phase stroke were screened for inclusion after electronic searches of multiple databases from inception to November 2016. The primary outcome was association with stroke-associated pneumonia. Summary Twelve studies of 87824 patients were included. The type of dysphagia screening protocol varied widely across and within studies. There was limited information on what comprised a specialist swallow assessment and alternative feeding was the only management strategy, which was reported for association with stroke-associated pneumonia. Use of a formal screening protocol, early dysphagia screening and assessment by a speech and language pathologist (SLP) was associated with a reduced risk of stroke-associated pneumonia. There was marked heterogeneity between the included studies, which precluded meta-analysis. Key Messages There is variation in assessment and management of dysphagia in acute stroke. There is increasing evidence that early dysphagia screening and specialist swallow assessment by a SLP may reduce the odds of stroke-associated pneumonia. There is the potential for other factors to influence incidence of stroke-associated pneumonia during the acute phase.

Item Type: Article
Research Institute, Centre or Group - Does NOT include content added after October 2018: Centre for Health and Social Care Research
Departments - Does NOT include content added after October 2018: Health and Well-being > Department of Allied Health Professions
Identification Number: https://doi.org/10.1159/000492730
Depositing User: Karen Sage
Date Deposited: 07 Aug 2018 11:43
Last Modified: 16 Nov 2018 13:17
URI: http://shura.shu.ac.uk/id/eprint/22229

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