Department of Communication Sciences and Disorders, MGH Institute of Health Professions, Boston, MA.
Department of Otolaryngology-Head and Neck Surgery, Boston Medical Center, MA.
Am J Speech Lang Pathol. 2019 Feb 21;28(1):188-194. doi: 10.1044/2018_AJSLP-18-0136.
Purpose The high incidence of swallowing and communication disorders following stroke is well documented. However, many of these studies have used retrospective chart reviews to make estimates of incidence and co-occurrence. The current study prospectively examined the incidence and co-occurrence of dysphagia, dysarthria, and aphasia following a 1st occurrence of ischemic stroke at an academic medical center hospital. Method One hundred patients who experienced their 1st ischemic stroke were recruited for participation in this study. All participants received a clinical swallowing evaluation to assess for dysphagia, administration of the Frenchay Dysarthria Assessment-Second Edition ( Enderby & Palmer, 2008 ) and Western Aphasia Battery-Revised ( Kertesz, 2006 ) to screen for the presence of dysarthria and aphasia, respectively. Results Incidence rates of dysphagia, dysarthria, and aphasia were 32%, 26%, and 16%, respectively. Forty-seven percent of participants had at least 1 of these disorders, 28% had 2 of these disorders, and 4% had all 3. Although the incidence rates in this study were smaller in magnitude than incidence rates in previous research, the pattern of results is broadly similar (i.e., dysphagia had the highest incidence rate, followed by dysarthria and, lastly, aphasia). Conclusions This prospective study yielded slightly lower incidence rates than have been previously obtained from retrospective chart reviews. The high incidence and co-occurrence of devastating swallowing and communication disorders post-ischemic stroke provides clear motivation for speech-language pathology involvement in the early phase of stroke rehabilitation.
目的 卒中后吞咽和交流障碍的高发病率已有充分记录。然而，许多这些研究使用回顾性图表审查来估计发病率和共病。目前的研究前瞻性地检查了学术医疗中心医院首次发生缺血性卒中后吞咽困难、构音障碍和失语症的发病率和共病。 方法 招募了 100 名经历首次缺血性卒中的患者参与本研究。所有参与者均接受了临床吞咽评估，以评估吞咽困难；使用 Frenchay 构音障碍评估第二版（Enderby 和 Palmer，2008）和 Western Aphasia Battery-Revised（Kertesz，2006）筛查构音障碍和失语症。 结果 吞咽困难、构音障碍和失语症的发病率分别为 32%、26%和 16%。47%的参与者至少有一种这些疾病，28%的参与者有两种，4%的参与者有三种。虽然本研究的发病率低于之前研究的发病率，但结果模式大致相似（即吞咽困难发病率最高，其次是构音障碍，最后是失语症）。 结论 这项前瞻性研究的发病率略低于之前从回顾性图表审查中获得的发病率。缺血性卒中后严重吞咽和交流障碍的高发病率和共病为言语病理学在卒中康复的早期阶段参与提供了明确的动机。
