Dysphagia, dysarthria and aphasia following a first acute ischaemic stroke: incidence and associated factors

• DOI: 10.1111/ene.14385
• Publication Date: 2020-06-09T09:09:41Z
• Authors: E. De Cock; K. Batens; D. Hemelsoet; P. Boon; K. Oostra; V. De Herdt
• Keywords: Male; Dysarthria; Incidence; Brain Ischemia; 3. Good health; Stroke; 03 medical and health sciences; 0302 clinical medicine; Aphasia; Humans; Female; Prospective Studies; Deglutition Disorders; Aged; Ischemic Stroke

Background and purposeDysphagia, dysarthria and aphasia are common symptoms following acute stroke; however, limited data are available from recent prospective clinical trials. The aim of this study was to determine the incidence and associated factors of dysphagia, dysarthria and aphasia following a first acute ischaemic stroke in patients admitted to a comprehensive stroke center.MethodsAll first ischaemic stroke patients admitted to the Stroke Unit of Ghent University Hospital within 48 h after symptom onset were enrolled in this prospective study between March 2018 and October 2019. Dysphagia and communication screenings were performed within 3 days after admission. When dysphagia, dysarthria and/or aphasia were assumed, standardized assessments were performed. Incidence rates were calculated as point estimates (%) with 95% confidence intervals (CI). Associated factors were calculated via multivariate binary logistic regression analyses.ResultsDysphagia, dysarthria and aphasia were present in 23% (95% CI, 17–31), 44% (95% CI, 37–52) and 23% (95% CI, 17–30), respectively of 151 first ischaemic stroke patients [67 female, mean age 67 (SD 14) years]. Separate multivariate binary logistic regression analyses showed that dysphagia, dysarthria and aphasia were significantly associated with age‐adjusted stroke severity at baseline [odds ratio (OR), 1.16; 95% CI, 1.09–1.23; OR, 1.13; 95% CI, 1.07–1.20 and OR, 1.11; 95% CI, 1.05–1.17 respectively]. Corrected for stroke severity, the risk for aphasia increased by 4% per year of age (OR, 1.04; 95% CI, 1.00–1.07). Adjusted for age and stroke severity, aphasia was significantly associated with large artery atherosclerosis as stroke etiology (OR, 3.91; 95% CI, 1.18–12.98).ConclusionsThis trial showed a high incidence of dysphagia, dysarthria and aphasia following acute ischaemic stroke. Stroke severity was an associated factor for all three symptoms.