Cough reflex testing in Dysphagia following stroke: a randomized controlled trial

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Journal Article
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Miles A
Zeng IS
McLauchlan H
Huckabee ML

Background: Significant health issues and service delivery costs are associated with post-stroke pneumonia related to dysphagia. Silent aspiration is known to increase pneumonia and mortality in this population. The utility of cough reflex testing (CRT) for reducing pneumonia in acute stroke patients was the subject of this randomised, controlled trial.

Methods: Patients referred for swallowing evaluation (N = 311) were assigned to either 1) a control group receiving standard evaluation or 2) an experimental group receiving standard evaluation with CRT. Participants in the experimental group were administered nebulised citric acid with test results contributing to clinical decisions. Outcomes for both groups were measured by pneumonia rates at 3 months post evaluation and other clinical indices of swallowing management.

Results: Analysis of the data identified no significant differences between groups in pneumonia rate (P = 0.38) or mortality (P = 0.15). Results of CRT were shown to influence diet recommendations (P < 0.0001) and referrals for instrumental assessment (P < 0.0001). Conclusions: Despite differences in clinical management between groups, the end goal of reducing pneumonia in post stroke dysphagia was not achieved.

Journal of Clinical Medicine Research (ISSN: 1918-3003, ESSN: 1918-3011) 2013 Jun; 5(3): 222–233.
Deglutition, Deglutition disorders, Dysphagia, Stroke care, Silent aspiration, Cough reflex testing, Pheumonia
Ngā upoko tukutuku/Māori subject headings
ANZSRC fields of research
Fields of Research::32 - Biomedical and clinical sciences::3202 - Clinical sciences::320209 - Gastroenterology and hepatology
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