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Dysphagia, Nutrition, and Hydration in Ischemic Stroke Patients at Admission and Discharge from Acute Care

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Abstract

Dysphagia may predispose stroke patients toward undernutrition and hydration. These comorbidities increase patient risks for reduced functional outcome and short-term mortality. Despite this impact, available information on relationships among dysphagia, nutrition, and hydration status in acute stroke is limited and conflicted. This study evaluated nutrition and hydration status in ischemic stroke patients with versus without clinically significant dysphagia at admission and at discharge from acute care. Sixty-seven patients admitted to the stroke unit in a tertiary-care hospital provided data for this study. On the day of hospital admission and upon discharge or at 7 days post admission, serum biochemical measures were obtained for nutrition (prealbumin) and hydration status (BUN/Cr). Clinical evaluation for dysphagia, nutrition status, and stroke severity were completed an average of 1.4 days following hospital admission. Dysphagia was identified in 37 % of the cohort. At admission 32 % of patients demonstrated malnutrition based on prealbumin levels and 53 % demonstrated evidence of dehydration based on BUN/Cr levels. No differences in nutrition status were attributed to dysphagia. Patients with dysphagia demonstrated significantly higher BUN/Cr levels (greater dehydration) than patients without dysphagia at admission and at discharge. Dehydration at both admission and discharge was associated with dysphagia, clinical nutrition status, and stroke severity. Results of this study support prior results indicating that dysphagia is not associated with poor nutrition status during the first week post stroke. Dehydration status is associated with dysphagia during this period. The results have implications for future confirmatory research and for clinical management of dysphagia in the acute stroke period.

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Conflict of interest

Michael A. Crary, Jamie L. Humphrey, Giselle Carnaby-Mann, Raam Sambandam, Leslie Miller, and Scott Silliman have no conflicts of interest to disclose.

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Authors and Affiliations

  1. Swallowing Research Laboratory, University of Florida Health Science Center, Box 100174, Gainesville, FL, 32610-0174, USA

    Michael A. Crary, Jamie L. Humphrey, Giselle Carnaby-Mann, Raam Sambandam, Leslie Miller & Scott Silliman

  2. Department of Speech, Language, and Hearing Sciences, College of Public Health and Health Professions, University of Florida, Gainesville, FL, 32610, USA

    Michael A. Crary

  3. Department of Geography, College of Arts and Sciences, University of Colorado at Boulder, Boulder, CO, 80309, USA

    Jamie L. Humphrey

  4. Department of Behavioral Science and Community Health, College of Public Health and Health Professions, University of Florida, Gainesville, FL, 32610, USA

    Giselle Carnaby-Mann

  5. Department of Neurology, University of Florida College of Medicine, Jacksonville, FL, 32209, USA

    Raam Sambandam & Scott Silliman

  6. Rehabilitation Services, Shands Hospital Jacksonville, Jacksonville, FL, 32209, USA

    Leslie Miller

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  1. Michael A. Crary
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  2. Jamie L. Humphrey
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  5. Leslie Miller
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  6. Scott Silliman
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Corresponding author

Correspondence to Michael A. Crary.

Additional information

Data Collection at Shands Hospital at Jacksonville. Data Analysis at Swallowing Research Laboratory, University of Florida Health Science Center.

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Crary, M.A., Humphrey, J.L., Carnaby-Mann, G. et al. Dysphagia, Nutrition, and Hydration in Ischemic Stroke Patients at Admission and Discharge from Acute Care. Dysphagia 28, 69–76 (2013). https://doi.org/10.1007/s00455-012-9414-0

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  • DOI: https://doi.org/10.1007/s00455-012-9414-0

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