European Stroke Organisation and European Society for Swallowing Disorders guideline for the diagnosis and treatment of post-stroke dysphagia

Dziewas, Rainer, Michou, Emilia, Trapl-Grundschober, Michaela, Lal, Avtar, Arsava, Murat, Bath, Philip M., Clavé, Pere, Glahn, Jörg, Hamdy, Shaheen, Pownall, Sue, Schindler, Antonio, Walshe, Margaret, Wirth, Rainer, Wright, David and Verin, Eric (2021) European Stroke Organisation and European Society for Swallowing Disorders guideline for the diagnosis and treatment of post-stroke dysphagia. European Stroke Journal, 6 (3). LXXXIX-CXV. ISSN 2396-9881

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Abstract

Post-stroke dysphagia (PSD) is present in more than 50% of acute stroke patients, increases the risk of complications, in particular aspiration pneumonia, malnutrition and dehydration, and is linked to poor outcome and mortality. The aim of this guideline is to assist all members of the multidisciplinary team in their management of patients with PSD. These guidelines were developed based on the European Stroke Organisation (ESO) standard operating procedure and followed the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. An interdisciplinary working group identified 20 relevant questions, performed systematic reviews and meta-analyses of the literature, assessed the quality of the available evidence and wrote evidence-based recommendations. Expert opinion was provided if not enough evidence was available to provide recommendations based on the GRADE approach. We found moderate quality of evidence to recommend dysphagia screening in all stroke patients to prevent post-stroke pneumonia and to early mortality and low quality of evidence to suggest dysphagia assessment in stroke patients having been identified at being at risk of PSD. We found low to moderate quality of evidence for a variety of treatment options to improve swallowing physiology and swallowing safety. These options include dietary interventions, behavioural swallowing treatment including acupuncture, nutritional interventions, oral health care, different pharmacological agents and different types of neurostimulation treatment. Some of the studied interventions also had an impact on other clinical endpoints such as feedings status or pneumonia. Overall, further randomized trials are needed to improve the quality of evidence for the treatment of PSD.

Item Type: Article
Additional Information: Article first published online: October 13, 2021
Uncontrolled Keywords: dysphagia,fees,stroke,swallowing,vfss,dysphagia screening,impaired deglutition,neurostimulation,screening,swallowing,videofluoroscopic swallowing study,dysphagia,stroke,flexible endoscopic evaluation of swallowing,clinical neurology,cardiology and cardiovascular medicine,sdg 2 - zero hunger ,/dk/atira/pure/subjectarea/asjc/2700/2728
Faculty \ School: Faculty of Science > School of Pharmacy
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Depositing User: LivePure Connector
Date Deposited: 21 Aug 2021 00:09
Last Modified: 20 Jan 2022 01:14
URI: https://ueaeprints.uea.ac.uk/id/eprint/81158
DOI: 10.1177/23969873211039721

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