Early Dysphagia Screening in Stroke Patients

Literature Review on Early Dysphagia Screening in Stroke Patients
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Literature Review on Early Dysphagia Screening in Stroke Patients
To establish what is already known about dysphagia screening in stroke patients and identify an information gap, if any, an electronic search was conducted. Cochrane Library, PubMed Central, and Google Scholar databases were used to search for articles that were no older than five years. The search terms ‘dysphagia in stroke patients,’ ‘dysphagia screening in stroke patients,’’ dysphagia and stroke-associated pneumonia,’ and ‘aspiration pneumonia in stroke patients’ were used. About thirty articles on the topic of dysphagia and pneumonia in stroke patients were yielded and are the focus of this literature review. The goal is to understand what is known about the topic in terms of what counts as early dysphagia screening, dysphagia incidence, predictors of dysphagia and dysphagia screening, as well as the effects of dysphagia screening on stroke patients.
Main Findings from the Literature Review
What Counts as Early Dysphagia Screening
In their article on delays in dysphagia screening after acute stroke, Bray et al. (2017) stipulate that there is a lack of robust evidence on how quickly dysphagia screening should be done to yield the required results. To fill this gap in information, they conducted a study on 63,650 patients with acute stroke. They established that in the first 24 hours, the risk of stroke-associated pneumonia increased by 3% and after 24 hours, the risk increased by an additional 4% (Bray et al., 2017). Indeed, the risk of developing stroke-associated pneumonia increases as the patient delays in receiving dysphagia screening. Grossmann et al. (2021) support this finding that the first few hours of admission are crucial for the detection of dysphagia and the prevention of stroke-associated pneumonia. Also, Eltringham et al. (2018) indicate that it is recommended for dysphagia screening to be done within 4-24 hours after hospital admission. It is unclear from the literature why dysphagia screening needs to wait for at least those 4 hours before it can be initiated. However, it is clear that dysphagia screening should occur within the first 24 hours after hospital admission. Any screening that occurs after 24 hours should not be considered an early intervention for stroke-associated pneumonia because the risks of developing pneumonia increase significantly after the first 24 hours.
Incidence of Dysphagia in Stroke Patients
Dysphagia is a common complication experienced by stroke patients and contributes to the risk of stroke-associated pneumonia. In a prospective clinical trial at a university hospital in Belgium, De Cock et al. (2020) established that the incidence of dysphagia among 151 stroke patients with first ischemic stroke was 23%. However, this incidence was lower than what has been reported previously in other clinical trials. It is unclear why the incidence was lower in this particular study. De Cock et al. (2020) claim that the incidence rate in their study was significantly lower can be substantiated by findings fr...