Study touts benefits of early dysphagia screening among stroke survivors

Early identification of dysphagia following acute stroke appears to have significant protective health benefits, such as minimizing the risks of pneumonia, mortality, overall dependency, and hospitalization duration, according to the results of a systematic review and meta-analysis.

The meta-analysis included 30 unique articles, of which 24 were observational studies and six were randomized controlled trials. Population sizes ranged from 101 to 143,578.

Across the studies, the dysphagia screening protocols used for early detection varied and included the Acute Screening of Swallow in Stroke/Transient Ischemic Attack, Gugging Swallowing Screen, Three‐Step Swallowing Screen protocol, and MetroHealth Dysphagia Screen. Comparisons were made between no screening vs screening, late vs earlier screening, informal vs formal screening, pre‐ vs postscreening, and pre‐ vs poststroke guidelines that included screening (control vs experimental protocol, respectively).

Pooled data from eight articles reporting the incidence of dysphagia from screening results showed that the frequency ranged from 20.5 percent to 62.3 percent.

Compared with the control protocol, experimental dysphagia screening conferred benefits for pneumonia (odds ratio [OR], 0.57, 95 percent confidence interval [CI], 0.45–0.72), mortality (OR, 0.52, 95 percent CI, 0.35–0.77), overall dependency (OR, 0.54, 95 percent CI, 0.35–0.85), and length of stay (standardized mean difference, −0.62, 95 percent CI, −1.05 to −0.20).

The benefit was especially evident when screening was administered by trained screeners soon after admission to hospital.

More studies are needed to further evaluate existing psychometrically sound screening protocols to identify those that provide the most benefit to the health of patients with stroke.