Acute Dysphagia Following Reperfusion Therapies: A Prospective Pilot Cohort Study.
Ellie Minchell, Anna Rumbach, Anna Farrell and 3 others
PMID 37380703WHAT IT FOUND
Dysphagia rates remained above 90% in the first 72 hours after stroke reperfusion therapies.
Higher initial stroke severity scores and poor clot removal outcomes predicted worse swallowing. These factors help SLPs triage risk, but the small pilot size limits certainty.
Key findings
01Incidence of any severity dysphagia within the first 24 hours was 92.31% (n=24/26), remaining high at 90.91% by 72 hours.
02Higher National Institutes of Health Stroke Scale (NIHSS) scores on arrival were significantly correlated with greater dysphagia severity at all three timepoints.
03Successful reperfusion (higher mTICI score) and fewer passes during thrombectomy were significantly correlated with lower dysphagia severity in the first 24 hours.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
Very small sample size (n=26) limits statistical power and generalisability. No control group was recruited because patients ineligible for reperfusion therapies often have different baseline characteristics. Assessment was limited to clinical screening (GUSS) without instrumental swallowing studies, though this reflects standard practice in the region. Post-treatment NIHSS scores were not routinely available, so the analysis relied on pre-treatment severity. Study recruitment was delayed by hospital closures during the pandemic, further reducing participant numbers.
Declared interests
Funded by the Royal Brisbane and Women's Hospital Foundation and The University of Queensland. No commercial conflicts of interest were declared.
The easy way to misread this
Do not assume that smaller infarct volumes guarantee safe swallowing. The study found no correlation between core or penumbra size and dysphagia severity, meaning patients with small visible strokes can still present with severe swallowing difficulties.