Dysphagia and Obstructive Sleep Apnea in Acute, First-Ever, Ischemic Stroke

Aldobrando Broccolini, Giacomo Della Marca, Valerio Brunetti, Pietro Caliandro, Giovanni Frisullo, Roberta Morosetti, Fabio Pilato, Paolo Profice, Elisa Testani, Catello Vollono, Maria Luisa Sacchetti

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background: Obstructive sleep apnea (OSA) and dysphagia are common in acute stroke and are both associated with increased risk of complications and worse prognosis. The aims of the present study were (1) to evaluate the prevalence of OSA and dysphagia in patients with acute, first-ever, ischemic stroke; (2) to investigate their clinical correlates; and (3) to verify if these conditions are associated in acute ischemic stroke. Methods: We enrolled a cohort of 140 consecutive patients with acute-onset (<48 hours), first-ever ischemic stroke. Computed tomography (CT) and magnetic resonance imaging scans confirmed the diagnosis. Neurological deficit was measured using the National Institutes of Health Stroke Scale (NIHSS) by examiners trained and certified in the use of this scale. Patients underwent a clinical evaluation of dysphagia (Gugging Swallowing Screen) and a cardiorespiratory sleep study to evaluate the presence of OSA. Results: There are 72 patients (51.4%) with obstructive sleep apnea (OSA+), and there are 81 patients (57.8%) with dysphagia (Dys+). OSA+ patients were significantly older (P =.046) and had greater body mass index (BMI) (P =.002), neck circumference (P =.001), presence of diabetes (P =.013), and hypertension (P <.001). Dys+ patients had greater NIHSS (P <.001), lower Alberta Stroke Programme Early CT Score (P <.001), with greater BMI (P =.030). The association of OSA and dysphagia was greater than that expected based on the prevalence of each condition in acute stroke (P <.001). Conclusions: OSA and dysphagia are associated in first-ever, acute ischemic stroke.
Original languageEnglish
Pages (from-to)539-546
Number of pages8
JournalJournal of Stroke and Cerebrovascular Diseases
Volume27
DOIs
Publication statusPublished - 2018

Keywords

  • Adult
  • Aged
  • Aged, 80 and over
  • Brain Ischemia
  • Cardiology and Cardiovascular Medicine
  • Comorbidity
  • Deglutition
  • Deglutition Disorders
  • Disability Evaluation
  • Female
  • Humans
  • Lung
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Neurology (clinical)
  • Prevalence
  • Prognosis
  • Rehabilitation
  • Respiration
  • Risk Factors
  • Rome
  • Sleep
  • Sleep Apnea, Obstructive
  • Stroke
  • Surgery
  • Time Factors
  • Tomography, X-Ray Computed
  • Young Adult
  • dysphagia
  • obstructive sleep apnea
  • sleep
  • sleep apnea

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