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Dysphagia

, Volume 31, Issue 1, pp 60–65 | Cite as

Clinical Variables Associated with Hydration Status in Acute Ischemic Stroke Patients with Dysphagia

  • Michael A. CraryEmail author
  • Giselle D. Carnaby
  • Yasmeen Shabbir
  • Leslie Miller
  • Scott Silliman
Original Article

Abstract

Acute stroke patients with dysphagia are at increased risk for poor hydration. Dysphagia management practices may directly impact hydration status. This study examined clinical factors that might impact hydration status in acute ischemic stroke patients with dysphagia. A retrospective chart review was completed on 67 ischemic stroke patients who participated in a prior study of nutrition and hydration status during acute care. Prior results indicated that patients with dysphagia demonstrated elevated BUN/Cr compared to non-dysphagia cases during acute care and that BUN/Cr increased selectively in dysphagic patients. This chart review evaluated clinical variables potentially impacting hydration status: diuretics, parenteral fluids, tube feeding, oral diet, and nonoral (NPO) status. Exposure to any variable and number of days of exposure to each variable were examined. Dysphagia cases demonstrated significantly more NPO days, tube fed days, and parenteral fluid days, but not oral fed days, or days on diuretics. BUN/Cr values at discharge were not associated with NPO days, parenteral fluid days, oral fed days, or days on diuretics. Patients on modified solid diets had significantly higher mean BUN/Cr values at discharge (27.12 vs. 17.23) as did tube fed patients (28.94 vs. 18.66). No difference was noted between these subgroups at baseline (regular diet vs. modified solids diets). Any modification of solid diets (31.11 vs. 17.23) or thickened liquids (28.50 vs. 17.81) resulted in significantly elevated BUN/Cr values at discharge. Liquid or diet modifications prescribed for acute stroke patients with dysphagia may impair hydration status in these patients.

Keywords

Hydration Deglutition Deglutition disorders Dysphagia Acute stroke Clinical management 

Notes

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

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Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Michael A. Crary
    • 1
    Email author
  • Giselle D. Carnaby
    • 1
  • Yasmeen Shabbir
    • 2
  • Leslie Miller
    • 3
  • Scott Silliman
    • 2
  1. 1.Swallowing Research Laboratory, Department of Communication Sciences and DisordersUniversity of Central FloridaOrlandoUSA
  2. 2.Department of NeurologyUniversity of Florida College of Medicine – JacksonvilleJacksonvilleUSA
  3. 3.Rehabilitation DepartmentUF Health-JacksonvilleJacksonvilleUSA

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