Dysphagia After Stroke: Incidence, Diagnosis, and Pulmonary Complications
Abstract
Objective To determine the incidence of dysphagia and associated pulmonary compromise in stroke patients through a systematic review of the published literature. Methods Databases were searched (1966 through May 2005) using terms "cerebrovascular disorders," "deglutition disorders," and limited to "humans" for original articles addressing the frequency of dysphagia or pneumonia. Data sources included Medline, Embase, Pascal, relevant Internet addresses, and extensive hand searching of bibliographies of identified articles. Selected articles were reviewed for quality, diagnostic methods, and patient characteristics. Comparisons were made of reported dysphagia and pneumonia frequencies. The relative risks (RRs) of developing pneumonia were calculated in patients with dysphagia and confirmed aspiration. Results Of the 277 sources identified, 104 were original, peer-reviewed articles that focused on adult stroke patients with dysphagia. Of these, 24 articles met inclusion criteria and were evaluated. The reported incidence of dysphagia was lowest using cursory screening techniques (37% to 45%), higher using clinical testing (51% to 55%), and highest using instrumental testing (64% to 78%). Dysphagia tends to be lower after hemispheric stroke and remains prominent in the rehabilitation brain stem stroke. There is increased risk for pneumonia in patients with dysphagia (RR, 3.17; 95% CI, 2.07, 4.87) and an even greater risk in patients with aspiration (RR, 11.56; 95% CI, 3.36, 39.7…
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Early screening and structured dysphagia management improve outcomes in acute stroke.
“Early screening and structured dysphagia management improve outcomes (Arnold et al., 2016; Martino et al., 2005), and enteral feeding strategies may be needed when aspiration risk is high (Duncan et al., 2020; Geeganage et al., 2012).”
From Autonomic nervous system and gastrointestinal manifestations with an emphasis on gastric dysfunction (2026) · cites this paper as Martino et al., 2005
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Eltringham, S. A., Smith, C. J., Bray, B., Richards, E., Burke, J., & Pownall, S. (2026) · International Journal of Language & Communication Disorders · doi:10.1111/1460-6984.70295
Autonomic nervous system and gastrointestinal manifestations with an emphasis on gastric dysfunction
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- Authors
- Martino, R., Foley, N., Bhogal, S., Diamant, N., Speechley, M., & Teasell, R.
- Affiliations
- Western University (CA)
- Venue
- Stroke
- Published
- 2005-12
- Volume
- 36
- Issue
- 12
- Pages
- 2756-2763
- ISSN
- 0039-2499 (ISSN-L)
- 1524-4628
- OpenAlex
- W2058038301
- Cited by
- 1,973
- References
- 0
- Citations by year
- 2026: 122 · 2025: 130 · 2024: 139 · 2023: 147 · 2022: 162 · 2021: 139 · 2020: 136 · 2019: 114 · 2018: 117 · 2017: 123 · 2016: 120 · 2015: 95 · 2014: 99 · 2013: 78 · 2012: 56
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Stroke (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Health Professions › Speech and Hearing › Dysphagia Assessment and Management
- Health Sciences › Medicine › Physiology › Voice and Speech Disorders
- Health Sciences › Medicine › Rehabilitation › Stroke Rehabilitation and Recovery
- Keywords
- dysphagia, aspiration pneumonia, stroke rehabilitation, brainstem infarction, hemispheric stroke, dysphagia screening, swallowing assessment
- MeSH terms
- Adult, Deglutition Disorders, Humans, Pneumonia, Comorbidity, Incidence, Stroke
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