Prevention of Pneumonia in Elderly Stroke Patients by Systematic Diagnosis and Treatment of Dysphagia: An Evidence-Based Comprehensive Analysis of the Literature
Dysphagia
Doggett, D. L., Tappe, K. A., et al. (2001).
Dysphagia, 16(4), 279-295.
This systematic review investigates the use of non-instrumental exams and instrumental assessments (e.g., videofluoroscopic study of swallowing, fiberoptic endoscopic evaluation) for diagnosis and treatment of dysphagia in elderly patients with stroke.
Agency for Healthcare Research and Quality
Through 1998
Published and unpublished studies
10
<div>The authors found that non-instrumental examination and instrumental examination (i.e., videofluoroscopic imaging, fiberoptic endoscopic evaluation of swallowing) demonstrated reduction in pneumonia rates. No studies allowed any meaningful comparisons to determine efficacy of different diagnostic tools.</div>
<div>The evidence indicates that implementation of a systematic program to diagnose and treat dysphagia in an acute stroke management plan may yield dramatic reductions in pneumonia rates. Because these data are derived from historically controlled studies rather than randomized controlled trials, it is difficult to determine the exact magnitude of pneumonia reduction rates and the "contribution of the dysphagia-specific aspects of the management programs to these [pneumonia] rate reductions. However, because the effects observed in these studies are substantial, it would be imprudent to ignore them, especially since these programs appear to have a minimal potential to harm patients" (p. 294).</div>
