Spontaneous Swallowing Frequency in Post-Stroke Patients with and Without Oropharyngeal Dysphagia : an Observational Study
Alvarez-Larruy, Marta (Universitat Autònoma de Barcelona. Departament de Cirurgia)
Tomsen, Noemí (Hospital de Mataró. Consorci Sanitari del Maresme)
Guanyabens i Giral, Nicolau (Universitat Autònoma de Barcelona. Departament de Cirurgia)
Palomeras, Ernest (Hospital de Mataró. Consorci Sanitari del Maresme)
Clavé i Civit, Pere (Universitat Autònoma de Barcelona. Departament de Cirurgia)
Nascimento, Weslania Viviane (Hospital de Mataró. Consorci Sanitari del Maresme)

Date:	2022
Abstract:	Oropharyngeal dysphagia (OD) is a frequent complication after stroke (PSOD) that increases morbidity and mortality. Early detection of PSOD is essential to reduce morbidity and mortality in patients with acute stroke. In recent years, an association between reduced spontaneous swallowing frequency (SSF) and OD has been described. Likewise, the reduction of saliva substance P (SP) concentration has been associated with an increased risk of aspiration and a decrease in SSF. In this study we aimed to compare SSF, salivary SP concentration, hydration and nutritional status in post-stroke (PS) patients with and without OD. We included 45 acute PS patients (4. 98 ± 2. 80 days from stroke onset, 62. 22% men, 71. 78 ± 13. 46 year). The Volume-Viscosity Swallowing Test (V-VST) was performed for clinical diagnosis of OD. SSF/minute was assessed through 10-min neurophysiological surface recordings including suprahyoid-electromyography and cricothyroid-accelerometry. Saliva samples were collected with a Salivette® to determine SP by ELISA. Hydration status was assessed by bioimpedance. Nutritional status was evaluated by Mini Nutritional Assessment Short Form (MNA-sf) and blood analysis. Twenty-seven PS patients (60%) had OD; 19 (40%), impaired safety of swallow. SSF was significantly reduced in PSOD, 0. 23 ± 0. 18 and PSOD with impaired safety, 0. 22 ± 0. 18 vs 0. 48 ± 0. 29 swallows/minute in PS without OD (PSnOD); (both p < 0. 005). Nutritional risk was observed in 62. 92% PSOD vs 11. 11% PSnOD (p = 0. 007) and visceral protein markers were also significantly reduced in PSOD (p < 0. 05). Bioimpedance showed intracellular dehydration in 37. 50% PSOD vs none in PSnOD. There were no differences for saliva SP concentrations. SSF is significantly reduced in PSOD in comparison with PSnOD. Acute PSOD patients present poor nutritional status, hydropenia, and high risk for respiratory complications.
Grants:	Instituto de Salud Carlos III ICI20/00117 Instituto de Salud Carlos III EHD20PI02 Instituto de Salud Carlos III PI18/00241
Note:	Altres ajuts: acords transformatius de la UAB
Note:	Altres ajuts: Generalitat de Catalunya, RIS3CAT, projectes d'especialització i competitivitat territorial (PECT) PRE/161/2019
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; Versió publicada
Subject:	Otorhinolaryngology ; Imaging / Radiology ; Gastroenterology ; Hepatology ; Spontaneous swallowing frequency ; Stroke ; Swallow ; Deglutition ; Oropharyngeal Dysphagia
Published in:	Dysphagia, 2022, p. 1-11, ISSN 1432-0460

DOI: 10.1007/s00455-022-10451-3
PMID: 35460440

11 p, 1.0 MB

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