Increasing risk of silent aspiration in stroke patients

Abstract

Dysphagia is a common complication of stroke that is often undiagnosed and leads to aspiration. This cross-sectional study aimed to detect the risk of silent aspiration during the swallowing process based on the location of the stroke lesion. A total of 48 stroke patients undergo a Fiberoptic Endoscopic Evaluation of Swallowing (FEES) examination to determine dysphagia profile based on penetration, standing secretion, residue, leakage, and silent aspiration. On the pre-swallowing assessment, there was an abnormal cough reflex and tongue movement weakness in 77.1% and 47.9% of patients. On the FEES assessment, penetration occurred in 72.9% of the patients and 100% of stroke patients with mixed lesions. Standing secretion occurred in 56.3% of the patients and 83.1% of stroke patients with brain stem lesions. Food residue occurred in 81.3% of patients and 100% of stroke patients with mixed lesions. Pre-swallowing leakage occurred in 91.7% of patients and 100% of stroke patients with mixed and brainstem lesions. Silent aspiration occurred in 29.2% of total patients and 60% of stroke patients with mixed lesions. The risk of silent aspiration in repeated strokes was five times higher than in first-stroke patients (P = 0.013). In conclusion, mixed lesions cause more severe oral and pharyngeal phase disorders as well as a higher risk of penetration and aspiration than other lesions.

Keywords

• stroke
• respiratory aspiration
• deglutition disorders
• swallowing
• dysphagia

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