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The impact of aspiration pneumonia and nasogastric feeding on clinical outcomes in stroke patients: A retrospective cohort study
Author(s) -
Schwarz Maria,
Coccetti Anne,
Murdoch Allison,
Cardell Elizabeth
Publication year - 2018
Publication title -
journal of clinical nursing
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.94
H-Index - 102
eISSN - 1365-2702
pISSN - 0962-1067
DOI - 10.1111/jocn.13922
Subject(s) - medicine , dysphagia , aspiration pneumonia , stroke (engine) , retrospective cohort study , pneumonia , intensive care medicine , emergency medicine , cohort , cohort study , population , physical therapy , surgery , mechanical engineering , environmental health , engineering
Aims and objectives To determine presence of clinical complications related to dysphagia and to explore their operational outcomes. Background Dysphagia is a common complication of stroke. The management of poststroke dysphagia is multidisciplinary with nurses playing a key role in screening for dysphagia risk, monitoring tolerance of food and fluids and checking for the development of complications such as fever, dehydration and change in medical status. Dysphagia often results in further complications including aspiration pneumonia and the need for nasogastric feeding. Dysphagia‐related complications have been shown to have a significant impact on morbidity and mortality, length of stay and cost of admission. Design Retrospective cohort study. Methods A total of 110 patients presenting with an ischaemic stroke were chart‐audited. Results Aspiration pneumonia poststroke was found to be significantly associated with increased overall length of stay, poorer functional outcomes poststroke as well as being associated with a high risk of mortality. The presence of a nasogastric tube was also associated with reduced functional outcomes poststroke and increased risk of death. Conclusion High prevalence and cost of complications associated with stroke highlight the complexity of providing nursing and allied health care to this patient population. This provides a snapshot of dysphagia‐related complications experienced by stroke patients. Relevance to clinical practice This paper highlights that poststroke complications can significantly impact on patient outcomes and operational factors such as cost of admission; therefore, poststroke care requires a multidisciplinary approach to management. Furthermore, preventing and managing complications poststroke is a key element of nursing care and has the potential to significantly reduce incidence of mortality, length of stay and cost of hospital admission.