부산대학교 도서관

Background and purpose: Post‐stroke dysphagia affects outcome. In acute stroke patients, the aim was to evaluate clinical, cognitive and neuroimaging features associated with dysphagia and develop a predictive score for dysphagia. Methods: Ischaemic stroke patients underwent clinical, cognitive and pre‐morbid function evaluations. Dysphagia was retrospectively scored on admission and discharge with the Functional Oral Intake Scale. Results: In all, 228 patients (mean age 75.8 years; 52% males) were included. On admission, 126 (55%) were dysphagic (Functional Oral Intake Scale ≤6). Age (odds ratio [OR] 1.03, 95% confidence interval [CI] 1.00–1.05), pre‐event modified Rankin scale (mRS) score (OR 1.41, 95% CI 1.09–1.84), National Institutes of Health Stroke Scale (NIHSS) score (OR 1.79, 95% CI 1.49–2.14), frontal operculum lesion (OR 8.53, 95% CI 3.82–19.06) and Oxfordshire total anterior circulation infarct (TACI) (OR 1.47, 95% CI 1.05–2.04) were independently associated with dysphagia at admission. Education (OR 0.91, 95% CI 0.85–0.98) had a protective role. At discharge, 82 patients (36%) were dysphagic. Pre‐event mRS (OR 1.28, 95% CI 1.04–1.56), admission NIHSS (OR 1.88, 95% CI 1.56–2.26), frontal operculum involvement (OR 15.53, 95% CI 7.44–32.43) and Oxfordshire classification TACI (OR 3.82, 95% CI 1.95–7.50) were independently associated with dysphagia at discharge. Education (OR 0.89, 95% CI 0.83–0.96) and thrombolysis (OR 0.77, 95% CI 0.23–0.95) had a protective role. The 6‐point "NOTTEM" (NIHSS, opercular lesion, TACI, thrombolysis, education, mRS) score predicted dysphagia at discharge with good accuracy. Cognitive scores had no role in dysphagia risk. Conclusions: Dysphagia predictors were defined and a score was developed to evaluate dysphagia risk during stroke unit stay. In this setting, cognitive impairment is not a predictor of dysphagia. Early dysphagia assessment may help in planning future rehabilitative and nutrition strategies. [ABSTRACT FROM AUTHOR]