Mind the gap!

The Third SSNAP Annual Report

Case Study: Importance of early assessments

Based on: The association between delays in screening for and assessing dysphagia after acute stroke, and the risk of stroke-associated pneumonia
Pneumonia (infection in the lungs) occurs frequently in people with acute stroke and adversely affects clinical outcomes. It trebles the risk of death, and is associated with worse disability in survivors. The combination of impaired cough and swallowing reflexes, and temporary suppression of the immune system after stroke are believed to be the main causes of the increased risk of pneumonia. Better ways of reducing the risk of pneumonia after stroke are urgently required.
Professor Craig Smith, based at the Greater Manchester Comprehensive Stroke Centre, Dr Ben Bray, of the RCP stroke programme and others, used data from SSNAP to investigate the association between delays in assessing patients’ swallowing after stroke and their risk of pneumonia. The study found a strong association between delays in receiving a speech and language therapy (SALT) swallow assessment and of the risk of pneumonia. Delays in SALT swallow assessment beyond 24 hours were associated with a 4% absolute increase in the incidence of pneumonia, after taking account of other patient factors.

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