Prediction of outcome in neurogenic oropharyngeal dysphagia within 72 hours of acute stroke: Comment

摘要

The authors investigated the null hypothesis: that an early prediction of severe, chronic, neurogenic, oropharyngeal dysphagia within 72 h of acute stroke was not possible. A total of 114 acute stroke patients with signs of aspiration received a clinical swallow examination within 24 h of admission and fiberoptic endoscopic evaluation of swallowing during the following 72 h. The Functional Communication Measure (FCM) [1] was the primary outcome variable on day 90. The FCM and the penetration-aspiration scale (PAS) [2] in the first 72 h was tested in a multivariate analysis for its predictive value for tube-feeding dependency on day 90. When the FCM level was 1–3 and the PAS score was 5–8, the area under the curve was 72.8 % with an odds ratio of 11.8, indicating a 12 times lower chance of being orally fed on day 90, i.e., tube-feeding dependent. Signs of aspiration during the first 72 h post stroke predicted severe swallowing problems on day 90.