Abstract
Objective: Possible contributing factors for developing pneumonia in the acute phase of brain stroke were evaluated from the viewpoint of dysphagia rehabilitation.
Subjects and Methods: Patient characteristics, swallowing function, lesions, and the presence or absence of dysphagia rehabilitation of 504 patients with acute brain hemorrhage or infarction were assessed to determine the association of these with the onset of pneumonia.
Results: Ninety-one patients (18.1%) contracted pneumonia. Of these, 38 developed pneumonia within 3 days of hospital admission and 53 developed the disease, 4 days or later. Thirty-nine patients developed pneumonia while they were fasting, 5 patients, after resuming oral food intake but before dysphagia rehabilitation, and 9, after dysphagia rehabilitation.
Conclusion: Pneumonia, common in elderly patients, especially in those with severe neurological symptoms or cognitive disorders, or with bilateral multiple lesions, is associated with prolonged length of stay in the hospital and decline in the activity of daily living (ADL) after discharge from the hospital. Inappropriate interventions may also cause pneumonia, and it will affectively lower the functional prognosis of the patient and decline in the ADL. Therefore, adequate caution must be exercised when starting oral food intake for acute stroke patients.
