Article Figures & Data
Figures
- Figure 1
The work flow of dysphagia evaluation in patients with acute stroke. V-VST, volume–viscosity swallow test.
- Figure 2
The comparison of levels of dysphagia recognised by V-VST and WST. All patients failed water test had a V-VST. Among them, 20 out of 79 were identified to have safe and effective swallowing capability. Twenty had only impaired swallowing safety and 10 had only impaired swallowing effectiveness. Patients with impaired safety or effectiveness received adjustment their food viscosity. Furthermore, all patients with unclear results on water test received a V-VST and their level of dysphagia were identified. V-VST, volume–viscosity swallow test; WST, water swallow test.
- Figure 3
The frequency of documented pneumonia and risk of pneumonia by stroke severity on screening. The screening frequency of documented pneumonia (solid line) and risk of pneumonia (dashed line) by stroke severity (only ischaemic stroke patients were included). Among them, 137 out of 230 patients had a pneumonia screening during their hospitalisation, and only 37 patients were diagnosed with CT scan or X-ray as having a pneumonia at discharge. The more severe the stroke, the higher the risk of pneumonia in these patients. However, the screening frequency of pneumonia also was increased due to the severity of stroke.
Tables
- Table 1
Baseline characteristics of patients with acute stroke who had WST and V-VST
WST (n=276) V-VST (n=276) P values* Negative (n=197) Positive (n=71) Unclear (n=8) P values Safety and efficacy (n=217) Impaired function† (n=59) P values Age, years old, mean+SD 61.23±13.94 65.07±12.17 65.38±16.65 0.091 61.29±13.75 66.22±12.65 0.014 0.611 Gender, males, % 143 (72.59) 50 (70.42) 4 (50.0) 0.375 159 (73.27) 38 (64.41) 0.182 0.626 Onset to admission, days, mean+SD 3.40±3.20 2.63±2.96 2.63±1.85 0.119 3.40±3.28 2.37±2.30 0.007 0.567 LOS, days, mean+SD 9.53±5.59 12.79±9.39 19.75±10.94 <0.001 9.54±5.42 14.85±10.76 <0.001 0.441 LOS in the ICU, days 0.86±2.62 2.37±4.03 3.75±3.88 0.001 0.98±2.87 2.63±3.83 0.003 0.866 Stroke subtype 0.790 0.743 0.849 Intracranial haemorrhage (n, %) 33 (16.75) 11 (15.49) 2 (25.0) 37 (17.05) 9 (15.25) Ischaemic stroke (n, %) 164 (83.25) 60 (84.51) 6 (75.0) 180 (82.95) 50 (84.75) Baseline characteristics Systolic blood pressure, mm Hg, median+IQR 151 (132-170) 154 (137-165) 156 (139-167) 0.845 151 (132-168) 154 (139-166) 0.288 0.830 Diastolic blood pressure, mm Hg, median+IQR 82 (74-92) 84 (76-92) 86 (75-97) 0.824 83 (75-93) 82 (75-92) 0.937 0.660 OCSP 0.003 0.002 0.470 Lacuna (n, %) 30 (15.23) 3 (4.23) / 33 (15.21) / Partial anterior circulation (n, %) 110 (55.84) 45 (60.38) 6 (75.00) 121 (55.76) 40 (67.80) Posterior circulation (n, %) 51 (25.89) 13 (18.31) 1 (12.50) 53 (24.42) 12 (20.34) Total anterior circulation (n, %) 6 (3.05) 10 (14.08) 1 (12.50) 10 (4.61) 7 (11.86) Risk factors Atrial fibrillation (n, %) 5 (2.54) 8 (11.27) 2 (25.00) 0.001 7 (3.23) 8 (13.56) 0.002 0.876 Diabetes mellitus (n, %) 54 (27.41) 22 (30.99) 2 (25.00) 0.830 58 (26.73) 20 (33.90) 0.278 0.661 Hypertension (n, %) 143 (72.59) 55 (77.46) 6 (75.00) 0.723 159 (73.27) 45 (76.27) 0.642 Smoking (n, %) 103 (52.28) 32 (45.07) 4 (50.00) 0.581 111 (51.15) 28 (47.46) 0.615 0.862 ↵*The difference between the patients failed water test and the patients failed volume– viscosity test.
↵†Impaired function in V-VST stands for impaired swallowing safety and/or effectiveness or failed to cooperate with the test.
ICU, intensive care unit; LOS, length of stay; OCSP, Oxfordshire Community Stroke Project; V-VST, volume–viscosity swallow test; WST, water swallow test.
- Table 2
The comparison of different levels of dysphagia in stroke patients by WST and V-VST
WST (n=79) V-VST
(n=59)Level II (n=26) Level III-IV (n=22) Level V (n=23) Unclear (n=8) P values Only safety impaired (n=20) Only efficacy impaired (n=10) Safety and efficacy impaired (n=29) P values Age, years old, mean+SD 63.69±11.45 65.05±12.72 66.70±12.75 65.38±16.65 0.856 67.25±11.24 67.00±15.54 65.14±12.84 0.076 Gender, males, % 18 (69.23) 14 (63.64) 18 (78.26) 4 (50.00) 0.471 17 (85.00) 5 (50.00) 16 (55.17) 0.058 Onset to admission, days, mean+SD 1.88±2.57 4.00±3.48 2.17±2.46 2.639.±1.85 0.051 2.40±2.72 2.40±2.27 3.10±4.69 3.049 LOS, days, mean+SD 10.96±5.55 10.23±3.72 17.30±14.16 19.75±10.94 0.002 11.35±5.05 19.50±19.30 15.31±9.45 0.197 LOS in the ICU, days 2.92±4.88 1.43±2.81 2.65±4.05 3.75±3.88 0.206 1.92±3.09 4.55±4.57 2.45±3.94 3.653 Tube feeding 3 (11.54) 1 (4.55) 14 (60.87) 6 (75.00) <0.001 4 (20.00) 5 (50.00) 15 (51.72) 0.173 Stroke subtype 0.693 0.859 Intracranial haemorrhage (n, %) 5 (19.23) 2 (9.09) 4 (17.39) 2 (25.00) 3 (15.00) 9 (90.00) 5 (17.24) Ischaemic stroke (n, %) 21 (80.77) 20 (90.90) 19 (82.61) 6 (75.00) 17 (85.00) 1 (10.00) 24 (82.76) OCSP 0.439 0.120 Lacuna (n, %) 2 (7.69) 1 (4.55) / / / / / Partial anterior circulation (n, %) 18 (69.23) 14 (63.64) 13 (56.52) 6 (75.00) 16 (80.00) 6 (60.00) 18 (62.07) Posterior circulation (n, %) 1 (3.84) 5 (22.73) 7 (30.43) 1 (12.50) 2 (100.00) 1 (10.00) 9 (31.03) Total anterior circulation (n, %) 5 (9.23) 2 (9.09) 3 (13.04) 1 (12.50) 2 (100.00) 3 (30.00) 2 (6.90) ICU, intensive care unit; LOS, length of stay; OCSP, Oxfordshire Community Stroke Project; V-VST, volume–viscosity swallow test; WST, water swallow test.
- Table 3
Baseline characteristics of patients with ischaemic stroke and haemorrhage stroke who did or did not have pneumonia
Documented No documented (n=113) P values* Negative (n=118) Positive (n=45) P values Age, years old, mean+SD 61.81±13.85 67.20±11.31 0.021 60.96±13.97 0.640 Gender, males, % 90 (76.27) 34 (75.56) 73 (64.60) 0.052 Onset to admission, days, mean+SD 3.22±3.23 2.58±2.73 0.238 3.38±3.15 0.703 LOS, days, mean+SD 10.96±7.25 12.82±11.21 0.213 9.50±4.54 0.071 LOS in the ICU, days 1.47±3.98 2.32±3.21 0.201 0.80±1.81 0.079 Tube feeding 10 (8.47) 9 (20.0) 0.040 6 (5.31) 0.344 Stroke subtype 0.694 0.616 Intracranial haemorrhage (n, %) 18 (15.25) 8 (17.78) 20 (17.70) Ischaemic stroke (n, %) 100 (84.75) 37 (82.22) 93 (82.30) Baseline characteristics Systolic blood pressure, mm Hg, median+IQR 152(138-166) 157(139-178) 0.218 147(127-168) 0.092 Diastolic blood pressure, mm Hg, median+IQR 86(78-93) 85(76-91) 0.695 83(73-92) 0.098 OCSP 0.229 Lacuna (n, %) 15 (12.71) 3 (6.67) 15 (13.27) Partial anterior circulation (n, %) 63 (53.39) 28 (62.22) 70 (61.95) Posterior circulation (n, %) 32 (27.12) 8 (17.78) 25 (22.12) Total anterior circulation (n, %) 8 (6.78) 6 (13.33) 3 (2.65) Risk factors Atrial fibrillation (n, %) 5 (4.24) 4 (8.89) 0.245 6 (5.31) 0.702 Diabetes mellitus (n, %) 27 (22.88) 16 (35.56) 0.101 35 (30.97) 0.165 Hypertension (n, %) 88 (74.58) 33 (73.33) 0.871 83 (73.45) 0.845 Smoking (n, %) 69 (58.47) 27 (60.0) 0.860 43 (83.05) 0.002 Outcome of WST 0.001 0.088 Negative 84 (71.18) 19 (42.22) 94 (83.19) Positive 30 (25.42) 25 (55.56) 16 (14.16) Unclear 4 (3.39) 1 (2.22) 3 (2.65) Outcome of V-VST <0.001 0.039 Safety and efficacy 94 (79.66) 24 (53.33) 99 (87.61) Only safety impaired 12 (10.17) 4 (8.89) 4 (3.54) Only efficacy impaired / 7 (15.56) 3 (2.65) Safety and efficacy impaired 12 (10.17) 10 (22.22) 7 (6.19) ↵*The difference between the patients with pneumonia and those without documentation
ICU, intensive care unit; LOS, length of stay; OCSP, Oxfordshire Community Stroke Project; V-VST, volume–viscosity swallow test; WST, water swallow test.
