Min jeong Leem¹, Hyun Im Moon^1,, Kee Hoon Kim¹

Background and Objectives: Acute and subacute stroke patients with dysphagia are at an increased risk of malnutrition and poor hydration. This study identified associations between dysphagia severity and the feeding method objectively selected based on videofluoroscopic swallowing study (VFSS) results, and the alteration of nutritional and hydration indicators after 2 months in stroke patients. Methods and Study Design: A retrospective chart review was completed including 120 patients with acute or subacute stroke who underwent VFSS in the Department of Physical Medicine between January 2010 and May 2017. For comparative analysis, we investigated the participants’ dysphagia severity using VFSS, nutrition and dehydration indicators, such as albumin, total protein, erythrocyte sedimentation rate, C-reactive protein, blood urea nitrogen, and creatinine at the time of admission and 2 months after admission. Results: The degree of poor hydration status increased with increasing severity of dysphagia at both time points. Furthermore, at 2 months after admission, as the severity of dysphagia increased, the frequency of malnutrition also increased. Albumin was significantly reduced in older adults with the same severity of dysphagia, especially in the aspiration group. Acute and subacute stroke patients with severe dysphagia had higher malnutrition and dehydration indicators 2 months after admission. Conclusion: Therefore, it is important to carefully monitor malnutrition and dehydration status in elderly patients with the same severity of dysphagia.

stroke, malnutrition, dehydration, elderly, videofluoroscopic swallowing study