Intensified post-stroke care improves long-term dysphagia recovery after acute ischemic stroke: Results from the STROKE CARD trial.

Autor:	Karisik A; Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria.; VASCage - Centre on Clinical Stroke Research, Innsbruck, Austria., Bader V; Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria., Moelgg K; Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria.; VASCage - Centre on Clinical Stroke Research, Innsbruck, Austria., Buergi L; Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria.; VASCage - Centre on Clinical Stroke Research, Innsbruck, Austria., Dejakum B; Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria., Komarek S; Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria., Boehme C; Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria., Toell T; Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria., Mayer-Suess L; Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria., Sollereder S; VASCage - Centre on Clinical Stroke Research, Innsbruck, Austria., Rossi S; ICONE - Innsbruck Cognitive Neuroscience, Department for Hearing, Speech and Voice Disorders, Medical University of Innsbruck, Innsbruck, Austria., Meier P; VASCage - Centre on Clinical Stroke Research, Innsbruck, Austria., Schoenherr G; Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria., Willeit J; Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria., Willeit P; Institute of Clinical Epidemiology, Public Health, Health Economics, Medical Statistics and Informatics, Medical University of Innsbruck, Innsbruck, Austria.; Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK., Lang W; VASCage - Centre on Clinical Stroke Research, Innsbruck, Austria.; Medical Faculty, Sigmund Freud Private University, Vienna, Austria., Kiechl S; Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria.; VASCage - Centre on Clinical Stroke Research, Innsbruck, Austria., Knoflach M; Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria.; VASCage - Centre on Clinical Stroke Research, Innsbruck, Austria., Pechlaner R; Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria.
Jazyk:	angličtina
Zdroj:	European stroke journal [Eur Stroke J] 2024 Oct 10, pp. 23969873241284123. Date of Electronic Publication: 2024 Oct 10.
DOI:	10.1177/23969873241284123
Abstrakt:	Introduction: Dysphagia is common after acute ischemic stroke and entails considerable morbidity and mortality. Here, we investigated the impact of intensified care on swallowing recovery after stroke. Patients and Methods: In this secondary analysis of STROKE-CARD, a randomized intervention trial of intensified post-stroke care, dysphagia was assessed by speech therapists at admission for acute ischemic stroke, at hospital discharge, and after 12-months. Patients randomized to STROKE-CARD care additionally received a detailed dysphagia follow-up at 3-months, including a standardized dysphagia examination, instructions on further exercises and compensation mechanisms and, if necessary, referral for further speech therapy. Results: Dysphagia was present initially after stroke in 236 (16.6%; median age 82 (73-88), 44.1% female) of 1419 patients, with similar prevalence in both study groups at hospital admission ( p  = 0.239) and discharge ( p  = 0.870). At follow up, 14 (9.5%) of 147 in the intervention group and 18 (20.2%) of 89 in the control group suffered from persistent dysphagia ( p  = 0.020). There was better dysphagia recovery in the intervention group also under multivariable adjustment for age, sex, functional disability at 12-months, severe dysphagia at hospitalization, mode of feeding, cognitive impairment, thrombolysis, and stroke localization (odds ratio, 0.41, 95% confidence interval: 0.17 to 0.96). Discussion and Conclusion: Intensified post-stroke care improved dysphagia recovery within 1 year after acute ischemic stroke, highlighting the potential of targeted interventions for enhancing stroke outcomes. Competing Interests: Declaration of conflicting interestThe author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: PW reports consultancy fees from Novartis Pharmaceuticals unrelated to this manuscript. The remaining authors report no disclosures relevant to this research.
Databáze:	MEDLINE
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