Speech Pathology Department, West Moreton Health, Queensland Health, Ipswich, Queensland, Australia.
School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, 4072, Australia.
Neurosurg Rev. 2020 Aug;43(4):1079-1087. doi: 10.1007/s10143-019-01155-8. Epub 2019 Aug 3.
There is currently limited information regarding dysphagia following non-traumatic subarachnoid haemorrhage (SAH), which impacts upon speech-language pathologists' (SLP) decisions when providing clinical care for this patient cohort. This scoping review aims to summarise the available evidence on the topic and identify gaps in the literature. The scoping review framework as described by Arskey and O'Malley (Soc Res Methodol 8(1):19-32, 2005) was used. Searches were undertaken in six databases. Inclusion criteria included that participants were adults (18+ years), with a primary diagnosis of non-traumatic SAH, and dysphagia occurred as a result of non-traumatic SAH. Data was extracted by the primary author independently and cross-checked by the second author. Data extracted included year of publication, study location, population, aims of the study, study design, method used to identify dysphagia, who completed the assessment, dysphagia incidence, dysphagia type and severity, risk factors, characteristics, and intervention details. Ten studies were included. Dysphagia was diagnosed based on staff reports, screening, clinical swallowing examination, and/or instrumental swallowing assessment with considerable variability identified across studies with regard to incidence (range 0.9-100%). Studies were highly heterogeneous with regard to dysphagia assessment practice, risk factors, characteristics, provision of intervention, and outcomes. The current evidence regarding dysphagia following non-traumatic SAH is insufficient to provide best practice guidelines for assessment and management recommendations. Emerging evidence will inform healthcare professionals managing dysphagia in individuals following non-traumatic SAH. Future research with more rigorous study designs will promote evidence-based clinical care standards for this population.
目前关于非创伤性蛛网膜下腔出血(SAH)后吞咽困难的信息有限,这影响了言语语言病理学家(SLP)在为这一患者群体提供临床护理时的决策。本范围综述旨在总结该主题的现有证据,并确定文献中的空白。使用了 Arskey 和 O'Malley(社会研究方法学 8(1):19-32,2005)描述的范围综述框架。在六个数据库中进行了搜索。纳入标准包括参与者为成年人(18 岁以上),原发性诊断为非创伤性 SAH,且吞咽困难是由非创伤性 SAH 引起的。主要作者独立提取数据,并由第二作者交叉检查。提取的数据包括出版年份、研究地点、人群、研究目的、研究设计、用于识别吞咽困难的方法、完成评估的人员、吞咽困难的发生率、吞咽困难的类型和严重程度、风险因素、特征和干预措施的详细信息。纳入了 10 项研究。吞咽困难是根据工作人员报告、筛查、临床吞咽检查和/或仪器吞咽评估来诊断的,不同研究之间的发生率存在相当大的差异(范围为 0.9-100%)。关于吞咽困难评估实践、风险因素、特征、干预措施提供和结果,这些研究在很大程度上存在异质性。目前关于非创伤性 SAH 后吞咽困难的证据不足以为评估和管理建议提供最佳实践指南。新出现的证据将为管理非创伤性 SAH 后吞咽困难的医疗保健专业人员提供信息。未来具有更严格研究设计的研究将促进针对这一人群的循证临床护理标准。