Swallowing Problem in Patients with Stroke: Multi-Center Study in Thailand
Pattra Wattanapan MD*,****** Apichana Kovindha MD**, Wuttichai Permsiripanich MD***, Nuttaset Manimmanakorn MD****, Vilai Kuptniratsaikul MD*****
Affiliation : * School of Rehabilitation Medicine, Institute of Medicine, Suranaree University of Technology, Nakhon Ratchasima, Thailand ** Rehabilitation Medicine Department, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand *** Department of Orthopedic Surgery and Rehabilitation Medicine, Prince of Songkla University, Songkhla, Thailand **** Department of Rehabilitation Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand ***** Rehabilitation Medicine Department, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok Thailand ****** Dysphagia Research Group, Khon Kaen University, Khon Kaen, Thailand
Background : Swallowing problems are a common symptom in patients suffering from stroke. The severity of swallowing
problems associate with age, stroke types, and brain lesion. Early recognition of the problem can prevent complications such
as aspiration pneumonia, and malnutrition.
Objective : To report the prevalence and the long-term outcome of dysphagia in patients with stroke.
Material and Method: Data of patients with stroke admitted at nine rehabilitation wards/centers in Thailand were extracted
from the Thai Stroke Rehabilitation Registry (TSRR) I and II (1-year follow-up).
Results : Of 327 stroke patients [mean age 62 (SD 12) years and male: female = 193:134], 49 (15%) had swallowing
dysfunction at admission. Dysphagic patients had significantly more cognitive impairment (TMSE score <24) than
non-dysphagic group (p = 0.01). There was no significant difference in age, gender, onset-admission interval, type of stroke,
and modified Barthel Index score (mBI) between the two groups. Moreover, there was no relationship between dysphagia and
poor functional outcome (mBI <12). One year after discharge, only 214 (65.4%) patients returned for follow-up and seven
patients (3.27%) had swallowing problem.
Conclusion : After a stroke attack, about 15% of patients had swallowing dysfunction. Those with cognitive impairment at
admission were more prone to swallowing functions impairment.
Keywords : Dysphagia, Stroke, Rehabilitation
