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

Dysphagia volume 31, pages 60–65 (2016)Cite this 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.

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Authors and Affiliations

  1. Swallowing Research Laboratory, Department of Communication Sciences and Disorders, University of Central Florida, Box 162215, Orlando, FL, 32826, USA

    Michael A. Crary PhD & Giselle D. Carnaby MPH, PhD

  2. Department of Neurology, University of Florida College of Medicine – Jacksonville, Jacksonville, FL, USA

    Yasmeen Shabbir MD & Scott Silliman MD

  3. Rehabilitation Department, UF Health-Jacksonville, Jacksonville, FL, USA

    Leslie Miller MA

Authors
  1. Michael A. Crary PhD
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  2. Giselle D. Carnaby MPH, PhD
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  3. Yasmeen Shabbir MD
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  4. Leslie Miller MA
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  5. Scott Silliman MD
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Correspondence to Michael A. Crary PhD.

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Crary, M.A., Carnaby, G.D., Shabbir, Y. et al. Clinical Variables Associated with Hydration Status in Acute Ischemic Stroke Patients with Dysphagia. Dysphagia 31, 60–65 (2016). https://doi.org/10.1007/s00455-015-9658-6

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  • DOI: https://doi.org/10.1007/s00455-015-9658-6

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