CoDAS vol.26 no.1 São Paulo Jan./Feb. 2014
Daiane Bassi 1
, Ana Maria Furkim 1
, Cristiane Alves Silva 2
, Mara Sérgia Pacheco Honório Coelho 1
, Maria Rita Pimenta Rolim 1
, Maria Luiza Aires de Alencar 1
, Marcos José Machado 1
)Universidade Federal de Santa Catarina – UFSC – Florianópolis (SC), Brazil
2)Fundação Catarinense de Educação Especial – FCEE – São José (SC), Brazil
To identify risk groups for oropharyngeal dysphagia in hospitalized patients in a university hospital.
The study was design as an exploratory cross-sectional with quantitative data analysis. The researched population consisted of 32 patients admitted to the medical clinic at the university hospital. Patient history data were collected, followed by a universal swallowing screening which included functional feeding assessment, to observe clinical signs and symptoms of dysphagia, and assessment of nutritional status through anthropometric data and laboratory tests.
Of the total sample, the majority of patients was male over 60 years. The most common comorbidities related to patients with signs and symptoms of dysphagia were chronic obstructive pulmonary disease, systemic arterial hypertension, congestive heart failure, diabetes mellitus and acute myocardial infarction. The food consistency that showed higher presence of clinical signs of aspiration was pudding and the predominant sign was wet voice.
There is a high incidence of risk for oropharyngeal dysphagia in hospitalized patients and an even higher rate of hospitalized patients with nutritional deficits or already malnourished. Hospitalized patients with respiratory diseases, chronic obstructive pulmonary disease, congestive heart failure and patients with xerostomia were indicated as risk group for oropharyngeal dysphagia.
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Rosemary Martino, Norine Foley, Sanjit Bhogal,Nicholas Diamant, Mark Speechley, Robert Teasell
Stroke. 2005; 36: 2756-2763
Objective— To determine the incidence of dysphagia and associated pulmonary compromise in stroke patients through a systematic review of the published literature.
Methods— Databases were searched (1966 through May 2005) using terms “cerebrovascular disorders,” “deglutition disorders,” and limited to “humans” for original articles addressing the frequency of dysphagia or pneumonia. Data sources included Medline, Embase, Pascal, relevant Internet addresses, and extensive hand searching of bibliographies of identified articles. Selected articles were reviewed for quality, diagnostic methods, and patient characteristics. Comparisons were made of reported dysphagia and pneumonia frequencies. The relative risks (RRs) of developing pneumonia were calculated in patients with dysphagia and confirmed aspiration.
Results— Of the 277 sources identified, 104 were original, peer-reviewed articles that focused on adult stroke patients with dysphagia. Of these, 24 articles met inclusion criteria and were evaluated. The reported incidence of dysphagia was lowest using cursory screening techniques (37% to 45%), higher using clinical testing (51% to 55%), and highest using instrumental testing (64% to 78%). Dysphagia tends to be lower after hemispheric stroke and remains prominent in the rehabilitation brain stem stroke. There is increased risk for pneumonia in patients with dysphagia (RR, 3.17; 95% CI, 2.07, 4.87) and an even greater risk in patients with aspiration (RR, 11.56; 95% CI, 3.36, 39.77).
Conclusions— The high incidence for dysphagia and pneumonia is a consistent finding with stroke patients. The pneumonia risk is greatest in stroke patients with aspiration. These findings will be valuable in the design of future dysphagia research.
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