Factors related to stroke-associated pneumonia in acute phases stroke after dysphagia screening and management at stroke unit
Keywords:
Acute stroke, factor-related pneumonia, stroke-associated pneumonia, dysphagia screeningAbstract
Objectives: To investigate potential factors linked to Stroke-Associated Pneumonia (SAP), we considered five variables: failure in the initial dysphagia screening test, manifestation of declining neurological signs, non-compliance with NPO (Nil Per Os) guidelines before the test, the duration from stroke onset to dysphagia screening, and the duration from admission date to dysphagia screening.
Methods: We conducted a retrospective analysis of the medical records of acute stroke patients admitted to the stroke unit between January 1, 2020, and December 31, 2022. Dysphagia screening tests were administered, and we compared two groups: those who presented with SAP and those without.
Results: We reviewed 358 medical records and randomly selected 100 patients by computer, categorizing them into SAP and no SAP, with 50 patients in each group. The SAP group exhibited higher stroke severity, and SAP was commonly diagnosed 2 to 3 days after the onset of the stroke. In our study, three factors were associated with SAP: a failed initial dysphagia screening (OR 11.03, 95% CI 1.88-64.66), the presence of declining neurological signs (OR 15.52, 95% CI 4.76-50.61), and non-compliance with NPO guidelines before the test (OR 16.23, 95% CI 3.01-87.77).
Conclusion: In acute stroke patients screened for dysphagia during hospitalization, SAP occurrence was associated with initial screening failure, worsening neurological signs, and non-compliance with NPO guidelines before the test. Although no correlation was observed between SAP and the timing of dysphagia screening, close monitoring and reassessment of swallowing issues, particularly within the first week post-stroke, is recommended for timely SAP detection.
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