ArticlePloS one2018
Systematic dysphagia screening and dietary modifications to reduce stroke-associated pneumonia rates in a stroke-unit.
Article in PloS one, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 2 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
23 citing papers in PubMed, 2 syntheses or guidelines pooled it, 57 citations in OpenAlex.
- Risk factors of dysphagia in patients with ischemic stroke: A meta-analysis and systematic review.PloS one · 2022Pooled it
- The Benefit of Dysphagia Screening in Adult Patients With Stroke: A Meta-Analysis.Journal of the American Heart Association · 2021Pooled it
- Medication Administration in Poststroke Dysphagia: Evaluating Swallowing Safety of Solid Dosage Forms.Stroke · 2025Trial
- The crux of NPO paradox revealed by increased pneumonia incidence in post-stroke dysphagia patients with dietary restrictions.Scientific reports · 2025Article
- Association between nutritional status and food texture levels in older patients with stroke-related sarcopenia in the subacute phase: a retrospective cross-sectional study.Frontiers in nutrition · 2025Article
- Gut microbiota dysbiosis drives stroke-associated pneumonia: mechanisms and targeted therapeutic strategies.Frontiers in neuroscience · 2025Review
- Machine learning predictive model for aspiration risk in early enteral nutrition patients with severe acute pancreatitis.Heliyon · 2024Article
- Article
- Prevalence, severity, and predictors of dysphagia among patients with acute stroke in Oman.Journal of education and health promotion · 2024Article
- Validation of a Geriatric Bedside Swallowing Screen (GEBS): Protocol of a Prospective Cohort Study.JMIR research protocols · 2023Article
- Clinical Practice Guidelines for Oropharyngeal Dysphagia.Annals of rehabilitation medicine · 2023Article
- A bedside swallowing screen for the identification of post-extubation dysphagia on the intensive care unit - validation of the Gugging Swallowing Screen (GUSS)-ICU.BMC anesthesiology · 2023Article
- Predictors of dysphagia screening and pneumonia among patients with acute ischaemic stroke in China: findings from the Chinese Stroke Center Alliance (CSCA).Stroke and vascular neurology · 2022Article
- Clinical Usefulness of the Korean Version of the Dysphagia Handicap Index: Reliability, Validity, and Role as a Screening Test.Dysphagia · 2022Article
- Are Oropharyngeal Dysphagia Screening Tests Effective in Preventing Pneumonia?Journal of clinical medicine · 2022Review
- Dysphagia Management and Outcomes in Elderly Stroke Patients with Malnutrition Risk: Results from Chinese Stroke Center Alliance.Clinical interventions in aging · 2022Article
- The Preventive Effect of Dysphagia Screening on Pneumonia in Acute Stroke Patients: A Systematic Review and Meta-Analysis.Healthcare (Basel, Switzerland) · 2021Review
- Reassessment of Poststroke Dysphagia in Rehabilitation Facility Results in Reduction in Diet Restrictions.Journal of clinical medicine · 2021Article
- Nurses' knowledge of stroke-related oropharyngeal dysphagia in the Eastern Cape, South Africa.The South African journal of communication disorders = Die Suid-Afrikaanse tydskrif vir Kommunikasieafwykings · 2020Article
- Silent dysphagia in two patients with Steinert disease and recurrent respiratory exacerbations.Acta myologica : myopathies and cardiomyopathies : official journal of the Mediterranean Society of Myology · 2020Article
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
background and purposeWhile formal screening for dysphagia following acute stroke is strongly recommended, there is little evidence on how multi-consistency screening and dietary modifications affect the rate of stroke-associated pneumonia (SAP). This observational study reports which factors affect formal screening on a stroke-unit and how dietary recommendations relate to SAP.
methodAnalyses from a database including 1394 patients admitted with acute stroke at our stroke-unit in Austria between 2012 and 2014. Dietary modifications were performed following the recommendations from the Gugging Swallowing Screen (GUSS). Patients evaluated with GUSS were compared to the unscreened patients.
resultsOverall, 993 (71.2%) patients were screened with GUSS; of these 50 (5.0%) developed SAP. In the 401 unscreened patients, the SAP rate was similar: 22 (5.5%). Multivariable analysis showed that either mild to very mild strokes or very severe strokes were less likely to undergo formal screening. Older age, pre-existing disability, history of hypertension, atrial fibrillation, stroke severity, cardiological and neurological complications, nasogastric tubes, and intubation were significant markers for SAP. Out of 216 patients, 30 (13.9%) developed SAP in spite of receiving nil per mouth (NPO).
conclusionThe routine use of GUSS is less often applied in either mild strokes or very severe strokes. While most patients with high risk of SAP were identified by GUSS and assigned to NPO, dietary modifications could not prevent SAP in 1 of 7 cases. Other causes of SAP such as silent aspiration, bacteraemia or central breathing disturbances should be considered.
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