Lower peak expiratory flow rate is associated with a higher risk of pneumonia in patients with stroke.
Wenxiu Wu, Jingjing Lin, Xuezhen Zhou and 5 others
PMID 39441112WHAT IT FOUND
Stroke patients with a peak expiratory flow below 60% of the expected value had a significantly higher risk of developing pneumonia during rehabilitation.
This simple bedside breathing test, combined with swallowing assessment and age, helps identify patients who need closer respiratory monitoring.
Key findings
01Patients with a peak expiratory flow (PEF) percentage below 60% had an independent risk of developing pneumonia that was 3.58 times higher than those with a PEF percentage above 80%.
02The combination of PEF percentage, swallowing function, and age predicted pneumonia development with an area under the curve of 0.857.
03Stroke patients had significantly lower PEF rates compared to healthy controls, even after adjusting for age, sex, and height.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for SLPs
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What it does not show
The study was conducted at a single center, which may limit how well the results apply to other populations. The patients had relatively mild strokes (median NIHSS score of 7.5), so the findings might not apply to patients with severe strokes. The PEF test was performed while the patient was seated, whereas guidelines often recommend standing. This may have slightly underestimated the PEF values. The Modified Volume-Viscosity Swallow Test cannot detect silent aspiration, which might have led to an underestimation of pneumonia risk in some patients.
Declared interests
The study was supported by a grant from the Wenzhou Municipal Sci-Tech Bureau Program. The authors declared no conflicts of interest.
The easy way to misread this
Do not use PEF alone to diagnose pneumonia or predict its onset with certainty. It is a marker of respiratory muscle strength and cough efficacy, but pneumonia development is multifactorial, involving swallowing safety and other clinical signs. A low PEF indicates increased risk, not a guaranteed outcome.