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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Post-acute Re-evaluation may Prevent Dysphagia-Associated Morbidity</title><author><name sortKey="Heckert, Kimberly D" sort="Heckert, Kimberly D" uniqKey="Heckert K" first="Kimberly D." last="Heckert">Kimberly D. Heckert</name></author><author><name sortKey="Komaroff, Eugene" sort="Komaroff, Eugene" uniqKey="Komaroff E" first="Eugene" last="Komaroff">Eugene Komaroff</name></author><author><name sortKey="Adler, Uri" sort="Adler, Uri" uniqKey="Adler U" first="Uri" last="Adler">Uri Adler</name></author><author><name sortKey="Barrett, Anna M" sort="Barrett, Anna M" uniqKey="Barrett A" first="Anna M." last="Barrett">Anna M. Barrett</name></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">19228843</idno><idno type="pmc">2742675</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2742675</idno><idno type="RBID">PMC:2742675</idno><idno type="doi">10.1161/STROKEAHA.108.533489</idno><date when="2009">2009</date><idno type="wicri:Area/Pmc/Corpus">002078</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">002078</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Post-acute Re-evaluation may Prevent Dysphagia-Associated Morbidity</title><author><name sortKey="Heckert, Kimberly D" sort="Heckert, Kimberly D" uniqKey="Heckert K" first="Kimberly D." last="Heckert">Kimberly D. Heckert</name></author><author><name sortKey="Komaroff, Eugene" sort="Komaroff, Eugene" uniqKey="Komaroff E" first="Eugene" last="Komaroff">Eugene Komaroff</name></author><author><name sortKey="Adler, Uri" sort="Adler, Uri" uniqKey="Adler U" first="Uri" last="Adler">Uri Adler</name></author><author><name sortKey="Barrett, Anna M" sort="Barrett, Anna M" uniqKey="Barrett A" first="Anna M." last="Barrett">Anna M. Barrett</name></author></analytic><series><title level="j">Stroke; a journal of cerebral circulation</title><idno type="ISSN">0039-2499</idno><idno type="eISSN">1524-4628</idno><imprint><date when="2009">2009</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec id="S1"><title>Background and Significance</title><p id="P1">Accurate identification and tailored management of patients with dysphagia is necessary to prevent complications when dysphagia is present and avoid implications of dietary restriction when unnecessary. Methods of dysphagia assessment vary, and a re-assessment in the post-acute period is not an established standard. The aim of this retrospective study was to compare initial dysphagia assessment with dysphagia re-assessment results for stroke patients admitted to our inpatient rehabilitation facility.</p></sec><sec sec-type="methods" id="S2"><title>Methods</title><p id="P2">We examined medical records of 226 acute stroke patients admitted to our inpatient rehabilitation facility from Dec 2006 to May 2007. We excluded 86 subjects, then noted the presence or absence of dysphagia based upon documentation and prescribed diet and management strategies in the remaining 146 records.</p></sec><sec id="S3"><title>Results</title><p id="P3">Dysphagia was identified in 94 patients (64%) assessed at our facility. Of these patients, 11% (n=10) were not previously identified in acute care (non-negligible number, p<.0001). Agreement regarding presence or absence of dysphagia occurred in 85%. However, prescribed diet differed in 51% (n=75), with 12% (n=18) requiring diet downgrades upon admission for rehabilitation.</p></sec><sec id="S4"><title>Conclusions</title><p id="P4">The necessity of dysphagia re-assessment as part of routine post-acute stroke rehabilitation care is not completely established. Our study supports the need for post-acute re-assessment as 11% of patients with dysphagia would not have been identified without re-assessment and 12% required diets more conservative than prescribed in acute care. Prospective research addressing dysphagia specific outcomes is warranted to develop efficient and high quality standards for preventing post-stroke dysphagia associated morbidity.</p></sec></div></front></TEI><pmc article-type="research-article" xml:lang="EN"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
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<front><journal-meta><journal-id journal-id-type="nlm-journal-id">0235266</journal-id><journal-id journal-id-type="pubmed-jr-id">7613</journal-id><journal-id journal-id-type="nlm-ta">Stroke</journal-id><journal-title>Stroke; a journal of cerebral circulation</journal-title><issn pub-type="ppub">0039-2499</issn><issn pub-type="epub">1524-4628</issn></journal-meta><article-meta><article-id pub-id-type="pmid">19228843</article-id><article-id pub-id-type="pmc">2742675</article-id><article-id pub-id-type="doi">10.1161/STROKEAHA.108.533489</article-id><article-id pub-id-type="manuscript">NIHMS109443</article-id><article-categories><subj-group subj-group-type="heading"><subject>Article</subject></subj-group></article-categories><title-group><article-title>Post-acute Re-evaluation may Prevent Dysphagia-Associated Morbidity</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Heckert</surname><given-names>Kimberly D.</given-names></name><degrees>MD</degrees><aff id="A1">Kessler Medical Rehabilitation Research and Education Center, University of Medicine and Dentistry of New Jersey</aff></contrib><contrib contrib-type="author"><name><surname>Komaroff</surname><given-names>Eugene</given-names></name><degrees>PhD</degrees><aff id="A2">Director, Biostatistics and Clinical Trials, Kessler Medical Rehabilitation Research and Education Center, Associate Professor of Physical Medicine & Rehabilitation, University of Medicine and Dentistry of New Jersey, New Jersey Medical School</aff></contrib><contrib contrib-type="author"><name><surname>Adler</surname><given-names>Uri</given-names></name><degrees>MD</degrees><aff id="A3">Assistant Professor of Physical of Medicine and Rehabilitation, University of Medicine and Dentistry of New Jersey, New Jersey Medical School, Director, Stroke Services, Kessler Medical Rehabilitation Research and Education Center</aff></contrib><contrib contrib-type="author"><name><surname>Barrett</surname><given-names>Anna M.</given-names></name><degrees>MD</degrees><aff id="A4">Associate Professor, Physical Medicine and Rehabilitation, Neurology and Neurosciences, University of Medicine and Dentistry of New Jersey, New Jersey Medical School, Director, Stroke Rehabilitation Research, Kessler Medical Rehabilitation Research and Education Center</aff></contrib></contrib-group><author-notes><corresp id="cor1">Name/address for correspondence and reprints: Kimberly Heckert, MD, 95 Mount Kemble Ave, Thebaud Building, 4th Floor, Morristown NJ 07690, Fax: 973-267-3144, Phone: 908-522-2134, Email: <email>kheckert@gmail.com</email></corresp><corresp id="cor2">Name/address for correspondence and reprints: Eugene Komaroff, PhD, 1199 Pleasant Valley Way, West Orange, NJ 07052, Fax: 973-324-3527, Phone: 973-324-6976, <email>ekomaroff@kmrrec.org</email></corresp><corresp id="cor3">Name/address for correspondence and reprints: Uri Adler, MD, 300 Market St, Saddle Brook, NJ 07663, Fax: 201-368-6135, Phone: 201-368-6051, <email>uadler@kessler-rehab.org</email></corresp><corresp id="cor4">Name/address for correspondence and reprints: Anna M. Barrett, MD, 1199 Pleasant Valley Way, West Orange, NJ 07052, Fax: 973-243-6984, Phone: 973-324-3569, <email>abarrett@kmrrec.org</email></corresp></author-notes><pub-date pub-type="nihms-submitted"><day>19</day><month>5</month><year>2009</year></pub-date><pub-date pub-type="epub"><day>19</day><month>2</month><year>2009</year></pub-date><pub-date pub-type="ppub"><month>4</month><year>2009</year></pub-date><pub-date pub-type="pmc-release"><day>1</day><month>4</month><year>2010</year></pub-date><volume>40</volume><issue>4</issue><fpage>1381</fpage><lpage>1385</lpage><abstract><sec id="S1"><title>Background and Significance</title><p id="P1">Accurate identification and tailored management of patients with dysphagia is necessary to prevent complications when dysphagia is present and avoid implications of dietary restriction when unnecessary. Methods of dysphagia assessment vary, and a re-assessment in the post-acute period is not an established standard. The aim of this retrospective study was to compare initial dysphagia assessment with dysphagia re-assessment results for stroke patients admitted to our inpatient rehabilitation facility.</p></sec><sec sec-type="methods" id="S2"><title>Methods</title><p id="P2">We examined medical records of 226 acute stroke patients admitted to our inpatient rehabilitation facility from Dec 2006 to May 2007. We excluded 86 subjects, then noted the presence or absence of dysphagia based upon documentation and prescribed diet and management strategies in the remaining 146 records.</p></sec><sec id="S3"><title>Results</title><p id="P3">Dysphagia was identified in 94 patients (64%) assessed at our facility. Of these patients, 11% (n=10) were not previously identified in acute care (non-negligible number, p<.0001). Agreement regarding presence or absence of dysphagia occurred in 85%. However, prescribed diet differed in 51% (n=75), with 12% (n=18) requiring diet downgrades upon admission for rehabilitation.</p></sec><sec id="S4"><title>Conclusions</title><p id="P4">The necessity of dysphagia re-assessment as part of routine post-acute stroke rehabilitation care is not completely established. Our study supports the need for post-acute re-assessment as 11% of patients with dysphagia would not have been identified without re-assessment and 12% required diets more conservative than prescribed in acute care. Prospective research addressing dysphagia specific outcomes is warranted to develop efficient and high quality standards for preventing post-stroke dysphagia associated morbidity.</p></sec></abstract><kwd-group><kwd>Acute Care</kwd><kwd>Acute Stroke</kwd><kwd>Cerebrovascular Accident</kwd><kwd>Diagnostic Methods</kwd><kwd>Dysphagia</kwd><kwd>Organized Stroke Care</kwd><kwd>Prevention</kwd><kwd>Quality of Life</kwd><kwd>Stroke Care</kwd><kwd>Morbidity</kwd><kwd>Post-acute Care</kwd></kwd-group><contract-num rid="NS1">K02 NS047099-06</contract-num><contract-num rid="NS1">K02 NS047099-05</contract-num><contract-num rid="NS1">K02 NS047099-04</contract-num><contract-sponsor id="NS1">National Institute of Neurological Disorders and Stroke : NINDS</contract-sponsor></article-meta></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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