Initial National Institute of Health Stroke Scale to Early Predict the Improvement of Swallowing in Patients with Acute Ischemic Stroke

doi:10.1016/j.jstrokecerebrovasdis.2019.07.013

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Title:	Initial National Institute of Health Stroke Scale to Early Predict the Improvement of Swallowing in Patients with Acute Ischemic Stroke
Authors:	Lin, Wen-Chih Huang, Chih-Yuan Lee, Lin-Fu Chen, Yun-Wen Chung-Han Ho(何宗翰) Sun, Yuan-Ting
Contributors:	Chi Mei Med Ctr, Chiali Branch, Dept Phys Med & Rehabil Natl Cheng Kung Univ, Natl Cheng Kung Univ Hosp, Coll Med, Dept Surg Natl Cheng Kung Univ, Coll Med, Dept Pharmacol Chia Nan Univ Pharm & Sci, Dept Hosp & Hlth Care Adm Chi Mei Med Ctr, Dept Med Res Natl Cheng Kung Univ, Natl Cheng Kung Univ Hosp, Coll Med, Dept Neurol Natl Cheng Kung Univ, Adv Optoelect Technol Ctr
Keywords:	Stroke prediction prognosis stroke scales dysphagia
Date:	2019-10
Issue Date:	2020-07-29 13:53:46 (UTC+8)
Publisher:	ELSEVIER
Abstract:	Objectives: To study the applicability of National Institutes of Health Stroke Scale (NIHSS) in early predicting the prognosis of poststroke dysphagia in an acute ward. Methods: This is an observational retrospective cohort study including adult patients with ischemic stroke. Patients with various factors affecting swallowing were excluded to obtain a representative sample of 165 patients. The main outcome measure was the improvements of oral intake function. Results: The scores of facial palsy (NIHSS item 4) (odds ratio [OR]: 0.484, 95% confidence interval [CI]: 0.279-0.838, P = .0096] and language/aphasia (NIHSS item 9) (OR: 0.562, 95% CI: 0.321-0.982, P = .0430) demonstrated significantly negative effects on the early improvement of dysphagia. Moreover, the improved patients had a 4.14-fold (95% CI: 2.53-11.23, P = .005) increased odds of returning home compared with nonimproved patients. Conclusions: Our findings provide evidence that early improvement of poststroke dysphagia was significantly associated with a favorable discharge destination and NIHSS items of facial palsy and language/aphasia can be used at the onset of stroke to identify dysphagic patients at risk of achieving limited improvement. These findings provide valuable prognostic indicators for clinicians to make a precise outcome prediction at very early stage.
Relation:	Journal of Stroke & Cerebrovascular Diseases, v.28, n.10, 104297
Appears in Collections:	[Dept. of Hospital and Health (including master's program)] Periodical Articles

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