ISSN: 1859 - 2872
Evaluation of the risk of pneumonia in stroke patients with dysphagia
Main Article Content
Keywords
Abstract
Objective: The aim of this study is to evaluate the characteristics of dysphagia and predict the risk of pneumonia in patients with stroke using the GUSS scale. Subject and method: This is a descriptive study. The ROC curve was used to evaluate the sensitivity (Se) and specificity (Sp) of the scale, and the area under the curve (AUC) was calculated. Result: The most common symptom of dysphagia was choking, which occurred in 18.7% of patients. The rate of aspiration was higher in the pneumonia group (39.8%) compared to the non-pneumonia group (15.3%), and this difference was statistically significant (p<0.05). Other common symptoms of dysphagia included coughing after eating (14.6%) and persistent hoarseness (12.6%). The proportion of patients with moderate and severe dysphagia (GUSS < 15) was 24.3%, and this was higher in the pneumonia group (69.9%) compared to the non-pneumonia group (17.0%). This difference was also statistically significant (p<0.05). The average GUSS score in the pneumonia group was 9.2 ± 6.6, while in the non-pneumonia group it was 17.0 ± 4.8, and this difference was statistically significant (p<0.05). The GUSS scale showed good predictive value for pneumonia with an AUC of 0.86 (95% CI 0.82-0.89), Se of 80.5%, and Sp of 80.1%. Univariate logistic regression analysis showed that severe and moderate dysphagia (GUSS < 15) was associated with a statistically significant increase in the risk of pneumonia with an OR of 11.4, p<0.05. Conclusion: The results of this study show that the GUSS scale has good predictive value for pneumonia in patients with stroke.
Article Details
References
2. Smith CJ, Kishore AK, Vail A, Chamorro A, Garau J, Hopkins SJ, Di Napoli M, Kalra L, Langhorne P, Montaner J, Roffe C, Rudd AG, Tyrrell PJ, van de Beek D, Woodhead M, Meisel A (2015) Diagnosis of stroke-associated pneumonia: Recommendations from the pneumonia in stroke consensus group. Stroke 46(8): 2335-2340.
3. Gamer J, Jarvis W, and Emori T (1996) CDC definitions of nosocomial infections. APIC infection control and applied epidemiology: 1-20.
4. Trapl M, Enderle P, Nowotny M, Teuschl Y, Matz K, Dachenhausen A, Brainin M (2007) Dysphagia bedside screening for acute-stroke patients: The gugging swallowing screen. Stroke 38(11): 2948-2952.
5. DeLong ER, DeLong DM, and Clarke-Pearson DL (1988) Comparing the areas under two or more correlated receiver operating characteristic curves: A nonparametric approach. Biometrics 44(3): 837-845.
6. Cugy E and Sibon I (2017) Stroke-associated pneumonia risk score: Validity in a french stroke unit. journal of Stroke and Cerebrovascular Diseases 26(1): 225-229.
7. Phan Nhựt Trí, Nguyễn Thị Thu Hương (2011) Nghiên cứu rối loạn nuốt theo GUSS ở bệnh nhân đột quỵ não cấp tại Bệnh viện Cà Mau năm 2010-2011. Nghiên cứu Y học, 3(74), tr. 167-170.
8. Smith CJ, Bray BD, Hoffman A, Meisel A, Heuschmann PU, Wolfe CD, Tyrrell PJ, Rudd AG; Intercollegiate Stroke Working Party Group (2013) Can a novel clinical risk score improve pneumonia prediction in acute stroke care? A UK multicenter cohort study. Journal of the American Heart Association 4(1): 1-10.
9. Ngô Thanh Bình, Nguyễn Văn Khôi (2013) Phân tích các yếu tố nguy cơ gây viêm phổi bệnh viện tại khoa hồi sức tích cực, Bệnh viện Khánh Hòa. Y học TP. HCM 17(1), tr. 78-87.
10. Chang MC, Choo YJ, Seo KC, Yang S (2022) The relationship between dysphagia and pneumonia in acute stroke patients: A systematic review and meta-analysis. Front Neurol. 2022 Mar 17;13:834240. doi: 10.3389/fneur.2022.834240.
Article Sidebar
