Dysphagia Assessment in Acute Ischemic Stroke Using High-resolution Manometry "DASH"

Completed

Phase N/A Results N/A

Trial Description

Dysphagia occurs relatively commonly in patients with acute stroke, and can lead to aspiration pneumonia and malnutrition. By using the stroke registry of our hospital, we will evaluate the feasibility and usefulness of Dysphagia screening in Acute Stroke using High-resolution impedance manometry (DASH). The hypothesis tested in this study is that high-resolution impedance manometry (HRiM) can provide the clinical efficacy to evaluate dysphagia and the diet plan in acute stroke patients.

Detailed Description

The hypothesis tested in this study was that high-resolution manometry can provide the clinical efficacy to evaluate dysphagia and the diet plan in acute stroke patients. By using of stroke registry of our hospital, we assessed feasibility and usefulness of Dysphagia screening in Acute Stroke using High-resolution impedance manometry in patients with acute stroke.
The registry had the contents of two evaluation steps; the first step was the process to identify the patients with risk of possible aspiration and the second step was for detection of silent aspirators.
Firstly, the patient was interviewed regarding difficulties with food intake, chewing and swallowing, and the neurological signs were confirmed by two independent neurologists. After then, the patients were stratified into three aspiration risk group and controlled by proper diet program. Finally the emergence of aspiration pneumonia was observed.

Conditions

Interventions

  • High-resolution impedance manometry test Procedure
    Other Names: ManoScan360 and ManoScanZ (Sierra Scientific Instruments, Los Angeles, CA).
    Intervention Desc: The test was performed as general guideline for high-resolution impedance manometry test. The parameter was obtained and analyzed using the Chicago classification for the liquid swallows with Takasaki's modification for pharyngeal function monitoring. Swallowing pattern and aspiration risk were defined using real-time assessment of high-resolution impedance manometry test.
    ARM 1: Kind: Experimental
    Label: Intermediate-risk aspiration group
    Description: If any one of following was positive, categorized to intermediate-risk group; (1) dysarthria, (2) motor aphasia, (3) inability to close and open lips or (4) facial weakness, (5) tongue deviation or (6) uvula deviation, (7) loss of gag reflex, and (8) inability to cough voluntarily.

Trial Design

  • Observation: Case-Only
  • Perspective: Retrospective
  • Sampling: Non-Probability Sample

Trial Population

Acute ischemic stroke patients at neurology department from April 2009 to November 2009 were evaluated.

Outcomes

Type Measure Time Frame Safety Issue
Primary Improvement of diet program Cases were followed for the duration of hospital stay, an average of 2 weeks. No
Primary Occurrence of aspiration pneumonia Cases were followed for the duration of hospital stay, an average of 2 weeks. No
Secondary Overall satisfaction measurement regarding program 1 month after study enrollment No

Sponsors