Fal stepwise backward binary logistic regression model optimizing the AIC criterion for the factors associated with undergoing a Gugging Swallowing Screen within 7 days (R² = 0.237, n = 1388).

<p>Fal stepwise backward binary logistic regression model optimizing the AIC criterion for the factors associated with undergoing a Gugging Swallowing Screen within 7 days (R² = 0.237, n = 1388).</p

Additional file 3: of Post-stroke pneumonia at the stroke unit – a registry based analysis of contributing and protective factors

“Three months mortality”, contains results of multivariate model on study patients with complete data on three months follow up, with mortality as dependent variable. (DOCX 82 kb

Systematic dysphagia screening and dietary modifications to reduce stroke-associated pneumonia rates in a stroke-unit

<div><p>Background and purpose</p><p>While formal screening for dysphagia following acute stroke is strongly recommended, there is little evidence on how multi-consistency screening and dietary modifications affect the rate of stroke-associated pneumonia (SAP). This observational study reports which factors affect formal screening on a stroke-unit and how dietary recommendations relate to SAP.</p><p>Method</p><p>Analyses from a database including 1394 patients admitted with acute stroke at our stroke-unit in Austria between 2012 and 2014. Dietary modifications were performed following the recommendations from the Gugging Swallowing Screen (GUSS). Patients evaluated with GUSS were compared to the unscreened patients.</p><p>Results</p><p>Overall, 993 (71.2%) patients were screened with GUSS; of these 50 (5.0%) developed SAP. In the 401 unscreened patients, the SAP rate was similar: 22 (5.5%). Multivariable analysis showed that either mild to very mild strokes or very severe strokes were less likely to undergo formal screening. Older age, pre-existing disability, history of hypertension, atrial fibrillation, stroke severity, cardiological and neurological complications, nasogastric tubes, and intubation were significant markers for SAP. Out of 216 patients, 30 (13.9%) developed SAP in spite of receiving nil per mouth (NPO).</p><p>Conclusion</p><p>The routine use of GUSS is less often applied in either mild strokes or very severe strokes. While most patients with high risk of SAP were identified by GUSS and assigned to NPO, dietary modifications could not prevent SAP in 1 of 7 cases. Other causes of SAP such as silent aspiration, bacteraemia or central breathing disturbances should be considered.</p></div

Characteristics of patients undergoing (n = 993) and not undergoing (n = 401) the Gugging Swallowing Screen (GUSS) within 7 days.

<p>Characteristics of patients undergoing (n = 993) and not undergoing (n = 401) the Gugging Swallowing Screen (GUSS) within 7 days.</p

Patient flowchart.

<p>GUSS: Gugging Swallowing Screen, HAP: hospital-acquired pneumonia (>7 days post-stroke); SAP: stroke-associated pneumonia (≤7 days post-stroke); SLT: speech and language therapist, SU: stroke-unit. *According to the discharge diagnosis based on neuroimaging findings.</p

Demographic factors, vascular risk factors, stroke related factors and treatment related factors in relation to incidence of stroke associated pneumonia (SAP).

<p>Demographic factors, vascular risk factors, stroke related factors and treatment related factors in relation to incidence of stroke associated pneumonia (SAP).</p

Final stepwise backward binary logistic regression model optimizing the AIC criterion for the factors associated with dysphagia (Gugging Swallowing Screen score <20 points; R² = 0.41; n = 990).

<p>Final stepwise backward binary logistic regression model optimizing the AIC criterion for the factors associated with dysphagia (Gugging Swallowing Screen score <20 points; R² = 0.41; n = 990).</p

Severity of dysphagia according to the first Gugging Swallowing Screen (GUSS) score after admission at the stroke-unit: no (20 points), slight (15–19 points), moderate (10–14 points), severe (0–9 points) dysphagia.

<p>Severity of dysphagia according to the first Gugging Swallowing Screen (GUSS) score after admission at the stroke-unit: no (20 points), slight (15–19 points), moderate (10–14 points), severe (0–9 points) dysphagia.</p

Diet that was administered according to the severity of dysphagia, measured with the Gugging Swallow Screen (GUSS).

<p>The number of stroke associated pneumonia (n = 50) are presented in parentheses; grey cells represent diet recommendations according to GUSS, cells above the grey cells indicate a diet less strict, cells below a diet stricter than recommended by GUSS; spotted cell indicate 8–9 points on the GUSS and administered to NPO-med diet.</p

Additional file 2: of Post-stroke pneumonia at the stroke unit – a registry based analysis of contributing and protective factors

“Pneumonie”, contains description of data selection process, frequencies of included variables, univariate comparisons and multivariate regression models. (DOCX 330 kb