ArticleEuropean journal of clinical nutrition2018
Impact of delay in early swallow screening on pneumonia, length of stay in hospital, disability and mortality in acute stroke patients.
Article in European journal of clinical nutrition, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
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Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it, 31 citations in OpenAlex.
- The Benefit of Dysphagia Screening in Adult Patients With Stroke: A Meta-Analysis.Journal of the American Heart Association · 2021Pooled it
- Machine Learning Methods to Predict the Length of Stay for Acute Stroke: A Scoping Review and Meta-Analysis.Health care science · 2026Review
- Exploration of the associations between dysphagia, liquid intake restrictions, and comorbidities in acute stroke: a retrospective chart review.Frontiers in rehabilitation sciences · 2026Article
- Article
- Initial encounter and discharge disposition of Medicare beneficiaries with post-stroke dysphagia.Frontiers in stroke · 2025Article
- Evidence and Recommendations for Acute Stroke Rehabilitation from the Japan Stroke Society: Abridged Secondary Publication of the Japanese-language Version.Progress in rehabilitation medicine · 2024Article
- Stroke Recovery Is a Journey: Prediction and Potentials of Motor Recovery after a Stroke from a Practical Perspective.Life (Basel, Switzerland) · 2023Article
- Clinical outcomes associated with speech, language and swallowing difficulties post-stroke.The South African journal of communication disorders = Die Suid-Afrikaanse tydskrif vir Kommunikasieafwykings · 2023Article
- Adverse stroke outcomes amongst UK ethnic minorities: a multi-centre registry-based cohort study of acute stroke.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2023Article
- Effects of an electronic health record-based mobility assessment and automated referral for inpatient physical therapy on patient outcomes: A quasi-experimental study.Health services research · 2023Article
- Best Practice Recommendations for Dysphagia Management in Stroke Patients: A Consensus from a Portuguese Expert Panel.Portuguese journal of public health · 2022Article
- European Stroke Organisation and European Society for Swallowing Disorders guideline for the diagnosis and treatment of post-stroke dysphagia.European stroke journal · 2021Article
- Prevalence and consequences of malnutrition and malnourishment in older individuals admitted to hospital with a hip fracture.European journal of clinical nutrition · 2021Article
- New evidence-based A1, A2, A3 alarm time zones for transferring thrombolysed patients to hyper-acute stroke units: faster is better.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2019Article
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Authors and funding
10 authors at 5 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND/
objectivesEarly swallow screening, within 4 h of admission, is required for all acute stroke patients to commence nutritional support, as recommended. We evaluated the impact of delay in early swallow screening on outcomes in patients admitted with acute stroke. SUBJECTS/
methodsProspective cohort study of 1656 men (mean ± SD age = 73.1y ± 13.2) and 1653 women (79.3y ± 13.0) admitted with stroke to hyperacute stroke units (HASUs) in Surrey. Logistic regression was used to assess the risk (adjusted for age, stroke severity and co-morbidities) of delay in swallow screening on pneumonia, length of stay (LOS) > 3 weeks in HASU or hospital, moderately severe to severe disability on discharge (modified Rankin scale score = 4-5) and mortality during admission.
resultsCompared with those who received swallow screening within 4 h of admission, a delay between 4 and 72 h was associated with greater risks of pneumonia: OR = 1.4 (95%CI:1.1-1.9, P = 0.022), moderately severe to severe disability on discharge: OR = 1.4 (1.1-1.7, P = 0.007) and a delay beyond 72 h was associated with even greater risks of pneumonia: OR = 2.3 (1.4-3.6, P < 0.001), prolonged LOS in HASU: OR = 1.7 (1.0-3.0, P = 0.047, median LOS = 6.2 vs. 14.7 days) and hospital: OR = 2.1-fold (1.3-3.4, P = 0.007, median LOS = 6.8 vs. 14.9 days), moderately severe to severe disability on discharge: OR = 2.5 (1.7-3.7, P < 0.001) and mortality: OR = 3.8 (2.5-5.6, P < 0.001). These risks persisted after excluding 103 patients who died within 72 h.
conclusionsDelay in early screening for swallow capacity in acute stroke patients is detrimental to outcomes, possibly due to delaying nutritional provision or through inappropriate feeding leading to aspiration. Routine early screening needs greater attention in HASUs.
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