Prevalence of pneumonia in swallowing disorders after stroke

Aim of the Study Pneumonia has been estimated to occur in about one third of dysphagia patients after acute stroke. The aim of our study was to determine the prevalence of pneumonia in a dysphagia group patients treated with early rehabilitation treatment in Acute Stroke Unit. We have compared our resulted with the data from literature. Methods Thirty-nine subjects (mean age 71.2) with oropharyngeal dysphagia after stroke were enrolled for this study. Clinical bedside swallow evaluation and fiberoptic endoscopic evaluation of swallowing (FEES) were performed at admission and after three months. All the patients were admitted to specific rehabilitation treatment for dysphagia within 5 days after stroke. The mean during of treatment was 9 days (range 5-24 days). The specific swallowing rehabilitation treatment included oral motor exercise, different swallowing techniques, positioning, diet modification, thermal-tactile stimulation, and pulmonary rehabilitation (ventilatory muscle training, etc.). Main outcome measure: retake oral feeding and pneumonia episodes. Results After 3 months, 24 patients show a complete recovery of swallowing, 6 patients seemed to present a significant improvement, but not complete recovery, 3 required nutritional supplement through percutaneous endoscopic gastrostomy, and 4 were death. The pneumonia prevalence has been of the 12.8 % (5 patients). Conclusions In literature the stroke patients with diysphagia show a prevalence of pneumonia between 34 and 65%. Our study shows that the prevalence of pneumonia is less than data from literature when the dysphagia patients were treated precociously. The long-term outcome was favourable. Our conclusion is that disphagia rehabilitation treatment is effective and necessary.