ArticleBMC neurology2019
Adjustment of oral diet based on flexible endoscopic evaluation of swallowing (FEES) in acute stroke patients: a cross-sectional hospital-based registry study.
Article in BMC neurology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 3 of them syntheses that pooled it.
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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
19 citing papers in PubMed, 3 syntheses or guidelines pooled it, 29 citations in OpenAlex.
- Pooled it
- Prevalence of dysphagia and risk of pneumonia and mortality in acute stroke patients: a meta-analysis.BMC geriatrics · 2022Pooled it
- Protocols and assessment procedures in fiberoptic endoscopic evaluation of swallowing: an updated systematic review.Brazilian journal of otorhinolaryngologyPooled it
- Post-Stroke Dysphagia: Moving Toward Evidence-Based, Recovery-Oriented Systems of Care.Current neurology and neuroscience reports · 2026Review
- Radiologic drivers of dysphagia after intracerebral haemorrhage: a flexible endoscopic evaluation of swallowing-guided retrospective analysis on intensive care unit.Neurological research and practice · 2026Article
- Compliance With Swallowing Instruction and Quality of Life in Patients With Parkinson's Disease: A Retrospective Assessment of Instructional Methods to Maintain and Improve Quality of Life.World journal of otorhinolaryngology - head and neck surgery · 2026Article
- Role of C-reactive protein and fibreoptic endoscopic evaluation of swallowing as early markers of stroke-associated pneumonia.Frontiers in stroke · 2026Article
- Oral Health Care for Post-Stroke Dysphagia Patients: A Systematic Review of Best Evidence.Journal of multidisciplinary healthcare · 2026Review
- Article
- Knowledge, Attitudes, and Practices Regarding Swallowing Disorders Among General Practitioners.International journal of general medicine · 2025Article
- Intensive care unit-acquired dysphagia - change in feeding route after a standardized dysphagia assessment in neurocritical care patients.Scientific reports · 2024Article
- Early flexible endoscopic evaluation of swallowing after mechanical thrombectomy in stroke patients.Annals of clinical and translational neurology · 2024Article
- 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
- Phoniatricians and otorhinolaryngologists approaching oropharyngeal dysphagia: an update on FEES.European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2022Review
- European Stroke Organisation and European Society for Swallowing Disorders guideline for the diagnosis and treatment of post-stroke dysphagia.European stroke journal · 2021Article
- Review
- Article
- Reassessment of Poststroke Dysphagia in Rehabilitation Facility Results in Reduction in Diet Restrictions.Journal of clinical medicine · 2021Article
- Isolated Dysphagia in a Patient with Medial Medullary Infarction - Effects of Evidence-Based Dysphagia Therapy: A Case Report.Case reports in neurologyArticle
Corrections and comments
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Authors and funding
8 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDiagnosing dysphagia in acute stroke patients is crucial, as this comorbidity determines morbidity and mortality; we therefore investigated the impact of flexible nasolaryngeal endoscopy (FEES) in acute stroke patients.
methodsThe FEES investigation as performed in acute stroke patients treated at a large university hospital, allocated as a standard procedure for all patients suspected of dysphagia. We correlated our findings with baseline data, disability status, pneumonia, duration of hospitalisation, necessity for mechanical ventilation and treatment on the intensive care unit. The study was designed as a cross-sectional hospital-based registry.
resultsWe investigated 152 patients. The median age was 73; 94 were male. Ischemic stroke was diagnosed in 125 patients (82.2%); 27 (17.8%) suffered intracerebral haemorrhage. Oropharyngeal dysphagia was diagnosed in 72.4% of the patients, and was associated with higher stroke severity on admission (median NIHSS 11 [IQR 6-17] vs. 7 [4-12], p = .013; median mRS 5 [IQR 4-5] vs. 4 [IQR 3-5], p = .012). Short-term mortality was higher among patients diagnosed with dysphagia (7.2% vs. 0%, p = .107). FEES examinations revealed that only 30.9% of the patients had an oral diet appropriate for their swallowing abilities. A change of oral diet was associated with a better outcome at discharge (mRS; p = .006), less need of mechanical ventilation (p = .028), shorter period of hospitalisation (p = .044), and lower rates of pneumonia (p = .007) and mortality (p = .011).
conclusionDue to the inability of clinical assessments to detect silent aspiration, FEES might be better suited to identify stroke patients at risk and may contribute to a better functional outcome and lower rates of pneumonia and mortality. Our findings also point to a low awareness of dysphagia, even in a specialised stroke centre. FEES in acute stroke patients helps to adjust the oral diet for the vast majority of stroke patients (69.1%) based on their swallowing abilities, potentially avoiding severe complications.
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