Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
Dysphagia
Published in: Dysphagia 1/2021

01-02-2021 | Stroke | Original Article

Post-stroke Complications and Mortality in Burkinabè Hospitals: Relationships with Deglutition Disorders and Nutritional Status

Authors: Jeoffray Diendéré, MD, PhD, Athanase Millogo, MD, Fayemendy Philippe, MD, Jean Kaboré, Christian Napon, MD, Anselme Dabilgou, MD, Marie-Paule Boncoeur-Martel, MD, Pierre-Marie Preux, MD, PhD, Jean-Yves Salle, MD, PhD, Jean-Claude Desport, MD, PhD, Pierre Jésus, MD, PhD

Published in: Dysphagia | Issue 1/2021

Login to get access

Abstract

Stroke frequently causes deglutition disorders, leading to a decline in nutritional status and complications, and increasing mortality. Sub-Saharan data are scarce. The objectives of this study were to assess complications and mortality among hospitalized patients in Burkina Faso during the first two weeks after stroke, and to investigate associated factors. Patients with stroke were followed prospectively in Ouagadougou and Bobo-Dioulasso hospitals. Deglutition disorders and nutritional parameters were assessed at baseline (D0) and on Days 8 (D8) and 14 (D14). Complications and mortality were recorded up to D14. Factors associated with complications and mortality were investigated using multivariate analysis. Of the 222 patients included, 81.5% developed at least one complication, and mortality was 17.1%. At D0, D8, and D14, the rate of deglutition disorders was 37.4%, 28.4%, and 15.8%, respectively, and that of undernourishment 25.2%, 29.4%, and 31.0%, respectively. In multivariate analysis, only the presence of deglutition disorders was a risk factor for developing at least one complication (OR = 5.47, 95% CI 1.81–16.51). Factors predicting death were the presence of deglutition disorders at D0 (OR = 7.19, 95% CI 3.10–16.66), and at least one seizure during follow-up (OR = 3.69, 95% CI 1.63–8.36). After stroke, the rates of complications, death, and undernourishment were high compared to Western countries. Prevention and management of deglutition disorders, and specific follow-up of patients with seizures could reduce post-stroke mortality.
Literature
1.
Martino R, Foley N, Bhogal S, Diamant N, Speechley M, Teasell R. Dysphagia after stroke: incidence, diagnosis, and pulmonary complications. Stroke. 2005;36:2756–63.PubMedCrossRef
2.
Baroni AFFB, Fábio SRC, Dantas RO. Risk factors for swallowing dysfunction in stroke patients. Arq Gastroenterol. 2012;49:118–24.PubMedCrossRef
3.
Mensah GA, Roth GA, Sampson UKA, Moran AE, Feigin VL, Forouzanfar MH, et al. Mortality from cardiovascular diseases in sub-Saharan Africa, 1990–2013: a systematic analysis of data from the Global Burden of Disease Study 2013. Cardiovasc J Afr. 2015;26:S6–10.PubMedPubMedCentralCrossRef
4.
Cohen DL, Roffe C, Beavan J, Blackett B, Fairfield CA, Hamdy S, et al. Post-stroke dysphagia: a review and design considerations for future trials. Int J Stroke. 2016;11:399–411.PubMedCrossRef
5.
Daniels SK, Anderson JA, Willson PC. Valid items for screening dysphagia risk in patients with stroke: a systematic review. Stroke. 2012;43:892–7.PubMedCrossRef
6.
Bryer A, Connor M, Haug P, Cheyip B, Staub H, Tipping B, et al. South African guideline for management of ischaemic stroke and transient ischaemic attack 2010: a guideline from the South African Stroke Society (SASS) and the SASS Writing Committee. S Afr Med J. 2010;100:747–78.PubMedCrossRef
7.
Ostrofsky C, Seedat J. The South African dysphagia screening tool (SADS): a screening tool for a developing context. S Afr J Commun Disord. 2016;63:1–9.CrossRef
8.
Miller N, Gray WK, Howitt SC, Jusabani A, Swai M, Mugusi F, et al. Aphasia and swallowing problems in subjects with incident stroke in rural northern Tanzania: a case-control study. Top Stroke Rehabil. 2014;21:52–62.PubMedCrossRef
9.
Zhou Z, Salle J, Daviet J, Stuit A, Nguyen C. Combined approach in bedside assessment of aspiration risk post stroke: PASS. Eur J Phys Rehabil Med. 2011;47:441–6.PubMed
10.
Guinvarch S, Preux PM, Salle JY, Desport JC, Daviet JC, Lissandre JP, et al. Proposal for a predictive clinical scale in dysphagia. Rev Laryngol Otol Rhinol. 1998;119:227.
11.
DePippo KL, Holas MA, Reding MJ. Validation of the 3-oz water swallow test for aspiration following stroke. Arch Neurol. 1992;49:1259–61.PubMedCrossRef
12.
Chumlea WC, Roche AF, Steinbaugh ML. Estimating stature from knee height for persons 60 to 90 years of age. J Am Geriatr Soc. 1985;33:116–20.PubMedCrossRef
13.
14.
15.
Heymsfield SB, McManus C, Smith J, Stevens V, Nixon DW. Anthropometric measurement of muscle mass: revised equations for calculating bone-free arm muscle area. Am J Clin Nutr. 1982;36:680–90.PubMedCrossRef
16.
Damasceno A, Gomes J, Azevedo A, Carrilho C, Lobo V, Lopes H, et al. An Epidemiological Study Of Stroke Hospitalizations In Maputo, Mozambique a high burden of disease in a resource–poor country. Stroke. 2010;41:2463–9.PubMedCrossRef
17.
Zabsonre P, Yameogo A, Millogo A, Dyemkouma FX, Durand G. Risk and severity factors in cerebrovascular accidents in west African Blacks of Burkina Faso. Med Trop (Mars). 1997;57:147–52.
18.
Jungehulsing GJ, Heuschmann PU, Holtkamp M, Schwab S, Kolominsky-Rabas PL. Incidence and predictors of post-stroke epilepsy. Acta Neurol Scand. 2013;127:427–30.PubMedCrossRef
19.
Teuschl Y, Brainin M, Matz K, Dachenhausen A, Ferrari J, Seyfang L, et al. Time trends in patient characteristics treated on acute stroke-units: results from the Austrian Stroke Unit Registry 2003–2011. Stroke. 2013;44:1070–4.PubMedCrossRef
20.
Watila MM, Balarabe SA. Factors predicting post-stroke aphasia recovery. J Neurol Sci. 2015;352:12–8.PubMedCrossRef
21.
Cossi M-J, Preux P-M, Chabriat H, Gobron C, Houinato D. Knowledge of stroke among an urban population in Cotonou (Benin). Neuroepidemiology. 2012;38:172–8.PubMedCrossRef
22.
Legg C, Penn C. A stroke of misfortune: Cultural interpretations of aphasia in South Africa. Aphasiology. 2013;27:126–44.CrossRef
23.
Desalu OO, Wahab KW, Fawale B, Olarenwaju TO, Busari OA, Adekoya AO, et al. A review of stroke admissions at a tertiary hospital in rural Southwestern Nigeria. Ann Afr Med. 2011;10:80–5.PubMedCrossRef
24.
Khellaf M, Quantin C, d’Athis P, Fassa M, Jooste V, Hervieu M, et al. Age-period-cohort analysis of stroke incidence in Dijon from 1985 to 2005. Stroke. 2010;41:2762–7.PubMedCrossRef
25.
Diendéré J, Sawadogo A, Millogo A, Ilboudo A, Napon C, Méda N, et al. Connaissances, attitudes et pratiques des infirmiers des centres de santé primaires concernant les troubles de la déglutition chez les patients hémiplégiques dans les districts sanitaires urbains de la région des Hauts-Bassins au Burkina Faso. Nutr Clin Metab. 2015;29:253–62.CrossRef
26.
27.
Odderson IR, Keaton JC, McKenna BS. Swallow management in patients on an acute stroke pathway: quality is cost effective. Arch Phys Med Rehabil. 1995;76:1130–3.PubMedCrossRef
28.
Okubo PCMI, Fábio SRC, Domenis DR, Takayanagui OM. Using the National Institute of Health Stroke Scale to predict dysphagia in acute ischemic stroke. Cerebrovasc Dis Basel Switz. 2012;33:501–7.CrossRef
29.
Arreola V, Vilardell N, Ortega O, Rofes L, Muriana D, Palomeras E, et al. Natural history of swallow function during the three-month period after stroke. Geriatr Basel Switz. 2019;4(3):42.CrossRef
30.
Blackwell Z, Littlejohns P. A review of the management of dysphagia: a South African perspective. J Neurosci Nurs. 2010;42:61–70.PubMedCrossRef
31.
Remesso GC, Fukujima MM, Chiappetta ALML, Oda AL, Aguiar AS, Oliveira ASB, et al. Swallowing disorders after ischemic stroke. Arq Neuropsiquiatr. 2011;69:785–9.PubMedCrossRef
32.
Arnold M, Liesirova K, Broeg-Morvay A, Meisterernst J, Schlager M, Mono M-L, et al. Dysphagia in acute stroke: incidence, burden and impact on clinical outcome. PLoS ONE. 2016;11:e0148424.PubMedPubMedCentralCrossRef
33.
Kidd D, Lawson J, Nesbitt R, MacMahon J. The natural history and clinical consequences of aspiration in acute stroke. QJM. 1995;88:409–13.PubMed
34.
Smithard DG, O’Neill PA, England RE, Park CL, Wyatt R, Martin DF, et al. The natural history of dysphagia following a stroke. Dysphagia. 1997;12:188–93.PubMedCrossRef
35.
Chai J, Chu FCS, Chow TW, Shum NC. Prevalence of malnutrition and its risk factors in stroke patients residing in an infirmary. Singap Med J. 2008;49:290–6.
36.
Mosselman MJ, Kruitwagen CLJJ, Schuurmans MJ, Hafsteinsdóttir TB. Malnutrition and risk of malnutrition in patients with stroke: prevalence during hospital stay. J Neurosci Nurs. 2013;45:194–204.PubMedCrossRef
37.
Zhang J, Zhao X, Wang A, Zhou Y, Yang B, Wei N, et al. Emerging malnutrition during hospitalisation independently predicts poor 3-month outcomes after acute stroke: data from a Chinese cohort. Asia Pac J Clin Nutr. 2015;24:379–86.PubMed
38.
Crary MA, Carnaby-Mann GD, Miller L, Antonios N, Silliman S. Dysphagia and nutritional status at the time of hospital admission for ischemic stroke. J Stroke Cerebrovasc Dis. 2006;15:164–71.PubMedCrossRef
39.
Pandian JD, Jyotsna R, Singh R, Sylaja PN, Vijaya P, Padma MV, et al. Premorbid nutrition and short term outcome of stroke: a multicentre study from India. J Neurol Neurosurg Psychiatry. 2011;82:1087–92.PubMedCrossRef
40.
Foley NC, Salter KL, Robertson J, Teasell RW, Woodbury MG. Which reported estimate of the prevalence of malnutrition after stroke is valid? Stroke. 2009;40:e66–74.PubMedCrossRef
41.
Frongillo EA, Nanama S. Development and validation of an experience-based measure of household food insecurity within and across seasons in northern Burkina Faso. J Nutr. 1419S;136:1409S–19S.PubMedCrossRef
42.
Dávalos A, Ricart W, Gonzalez-Huix F, Soler S, Marrugat J, Molins A, et al. Effect of malnutrition after acute stroke on clinical outcome. Stroke. 1996;27:1028–32.PubMedCrossRef
43.
Gariballa SE, Parker SG, Taub N, Castleden CM. Influence of nutritional status on clinical outcome after acute stroke. Am J Clin Nutr. 1998;68:275–81.PubMedCrossRef
44.
Ballesteros Pomar MD, Palazuelo AL. How is the patient’s nutrition after a stroke? Nutr Hosp. 2017;34:46–56.PubMedCrossRef
45.
Wirth R, Smoliner C, Jäger M, Warnecke T, Leischker AH, Dziewas R. Guideline clinical nutrition in patients with stroke. Exp Transl Stroke Med. 2013;5:14.PubMedPubMedCentralCrossRef
46.
47.
Mamushet Y, Zenebe G, Addissie A. Medical and neurological complications among stroke patients admitted for inpatient care in Addis Ababa, Ethiopia. Ethiop Med J. 2015;53:9–17.PubMed
48.
Hung J-W, Tsay T-H, Chang H-W, Leong C-P, Lau Y-C. Incidence and risk factors of medical complications during inpatient stroke rehabilitation. Chang Gung Med J. 2005;28:31–8.PubMed
49.
Ingeman A, Andersen G, Hundborg HH, Svendsen ML, Johnsen SP. In-hospital medical complications, length of stay, and mortality among stroke unit patients. Stroke. 2011;42:3214–8.PubMedCrossRef
50.
Nkoke C, Lekoubou A, Balti E, Kengne AP. Stroke mortality and its determinants in a resource-limited setting: a prospective cohort study in Yaounde, Cameroon. J Neurol Sci. 2015;358:113–7.PubMedCrossRef
51.
Ansa VO, Oyo-Ita A, Essien OE. Perception of ischaemic heart disease, knowledge of and attitude to reduction of its risk factors. East Afr Med J. 2007;84:318–23.PubMed
52.
Arnberg F, Grafström J, Lundberg J, Nikkhou-Aski S, Little P, Damberg P, et al. Imaging of a clinically relevant stroke model: glucose hypermetabolism revisited. Stroke. 2015;46(3):835–42.PubMedCrossRef
53.
Muir KW, McCormick M, Baird T, Ali M. Prevalence, predictors and prognosis of post-stroke hyperglycaemia in acute stroke trials: individual patient data pooled analysis from the Virtual International Stroke Trials Archive (VISTA). Cerebrovasc Dis Extra. 2011;1:17–27.PubMedPubMedCentralCrossRef
54.
Westendorp WF, Nederkoorn PJ, Vermeij J-D, Dijkgraaf MG, van de Beek D. Post-stroke infection: a systematic review and meta-analysis. BMC Neurol. 2011;11:110.PubMedPubMedCentralCrossRef
55.
Hoffmann S, Malzahn U, Harms H, Koennecke H-C, Berger K, Kalic M, et al. Development of a clinical score (A2DS2) to predict pneumonia in acute ischemic stroke. Stroke. 2012;43:2617–23.PubMedCrossRef
56.
Langmore SE, Terpenning MS, Schork A, Chen Y, Murray JT, Lopatin D, et al. Predictors of aspiration pneumonia: how important is dysphagia? Dysphagia. 1998;13:69–81.PubMedCrossRef
57.
Ersoz M, Ulusoy H, Oktar MA, Akyuz M. Urinary tract infection and bacteriuria in stroke patients: frequencies, pathogen microorganisms, and risk factors. Am J Phys Med Rehabil. 2007;86:734–41.PubMedCrossRef
58.
Stott DJ, Falconer A, Miller H, Tilston JC, Langhorne P. Urinary tract infection after stroke. QJM. 2009;102:243–9.PubMedCrossRef
59.
Alberti A, Paciaroni M, Caso V, Venti M, Palmerini F, Agnelli G. Early seizures in patients with acute stroke: frequency, predictive factors, and effect on clinical outcome. Vasc Health Risk Manag. 2008;4:715–20.PubMedPubMedCentralCrossRef
60.
Reith J, Jørgensen HS, Nakayama H, Raaschou HO, Olsen TS. Seizures in acute stroke: predictors and prognostic significance the Copenhagen stroke study. Stroke. 1997;28:1585–9.PubMedCrossRef
61.
Napon C, Dabilgou A, Kyelem J, Kaboré J. Post-stroke epilepsy in Burkina Faso (West Africa). J Neurol Sci. 2016;368:47–8.PubMedCrossRef
62.
Posthauer ME, Banks M, Dorner B, Schols JMGA. The role of nutrition for pressure ulcer management: national pressure ulcer advisory panel, European pressure ulcer advisory panel, and pan pacific pressure injury alliance white paper. Adv Skin Wound Care. 2015;28:175–88; quiz 189–90.
63.
Pinchcofsky-Devin GD, Kaminski MV. Correlation of pressure sores and nutritional status. J Am Geriatr Soc. 1986;34:435–40.PubMedCrossRef
64.
Ek A-C, Unosson M, Larsson J, Von Schenck H, Bjurulf P. The development and healing of pressure sores related to the nutritional state. Clin Nutr. 1991;10:245–50.PubMedCrossRef
65.
Dewan KR, Rana PVS. A study of seven day mortality in acute ischemic stroke in a teaching hospital in Chitwan. J Nepal Health Res Counc. 2014;12:33–8.PubMed
66.
Nakibuuka J, Sajatovic M, Nankabirwa J, Ssendikadiwa C, Furlan AJ, Katabira E, et al. Early mortality and functional outcome after acute stroke in Uganda: prospective study with 30 day follow-up. SpringerPlus. 2015;4:450.PubMedPubMedCentralCrossRef
67.
Razafindrasata RS, Rasaholiarison NF, Razafimahefa J, Tehindrazanarivelo AD. Motor deficit outcome in patients with stroke in the neurology unit of the Befelatanana University Hospital in Antananarivo. Med Sante Trop. 2017;27:421–5.PubMed
68.
Komolafe MA, Ogunlade O, Komolafe EO. Stroke mortality in a teaching hospital in South Western Nigeria. Trop Doct. 2007;37:186–8.PubMedCrossRef
69.
Njoku CH, Aduloju AB. Stroke in Sokoto, Nigeria: A FIVE year retrospective study. Ann Afr Med. 2004;3:73–6.
70.
Schmidt A, Heroum C, Caumette D, Le Lay K, Bénard S. Acute Ischemic Stroke (AIS) patient management in French stroke units and impact estimation of thrombolysis on care pathways and associated costs. Cerebrovasc Dis. 2015;39:94–101.PubMedCrossRef
71.
Silver FL, Norris JW, Lewis AJ, Hachinski VC. Early mortality following stroke: a prospective review. Stroke. 1984;15:492–6.PubMedCrossRef
72.
Béjot Y, Aboa-Eboulé C, de Maistre E, Jacquin A, Troisgros O, Hervieu M, et al. Prestroke antiplatelet therapy and early prognosis in stroke patients: the Dijon Stroke Registry. Eur J Neurol. 2013;20:879–90.PubMedCrossRef
73.
Grabska K, Gromadzka G, Członkowska A. Prestroke antihypertensive therapy: effect on the outcome. Clin Exp Hypertens. 2013;35:141–7.PubMedCrossRef
74.
Guyomard V, Fulcher RA, Redmayne O, Metcalf AK, Potter JF, Myint PK. Effect of dysphasia and dysphagia on inpatient mortality and hospital length of stay: a database study. J Am Geriatr Soc. 2009;57:2101–6.PubMedCrossRef
75.
Arboix A, García-Eroles L, Massons JB, Oliveres M, Comes E. Predictive factors of early seizures after acute cerebrovascular disease. Stroke. 1997;28:1590–4.PubMedCrossRef
76.
Goswami RP, Karmakar PS, Ghosh A. Early seizures in first-ever acute stroke patients in India: incidence, predictive factors and impact on early outcome. Eur J Neurol. 2012;19:1361–6.PubMedCrossRef
77.
Napon C, Dabilgou A, Kyelem J, Bonkoungou P, Kaboré J. Therapeutic route of patients at the acute phase of their stroke in Burkina Faso. J Neurol Sci. 2017;372:75–7.PubMedCrossRef
78.
The Food trial Collaboration. Poor nutritional status on admission predicts poor outcomes after stroke observational data from the FOOD trial. Stroke. 2003;34:1450–6.CrossRef
79.
80.
Walker RW, Rolfe M, Kelly PJ, George MO, James OFW. Mortality and recovery after stroke in the Gambia. Stroke. 2003;34:1604–9.PubMedCrossRef
81.
Sagui E, M’Baye PS, Dubecq C, Ba Fall K, Niang A, Gning S, et al. Ischemic and hemorrhagic strokes in Dakar, Senegal: a hospital-based study. Stroke. 2005;36:1844–7.PubMedCrossRef
82.
Garbusinski JM, van der Sande MAB, Bartholome EJ, Dramaix M, Gaye A, Coleman R, et al. Stroke presentation and outcome in developing countries: a prospective study in the Gambia. Stroke. 2005;36:1388–93.PubMedCrossRef
83.
Napon C, Tougma L, Kaboré R. Prognosis for motor deficits after strokes in Burkina Faso. Med Sante Trop. 2013;23:320–3.PubMed
Metadata
Title
Post-stroke Complications and Mortality in Burkinabè Hospitals: Relationships with Deglutition Disorders and Nutritional Status
Authors
Jeoffray Diendéré, MD, PhD
Athanase Millogo, MD
Fayemendy Philippe, MD
Jean Kaboré
Christian Napon, MD
Anselme Dabilgou, MD
Marie-Paule Boncoeur-Martel, MD
Pierre-Marie Preux, MD, PhD
Jean-Yves Salle, MD, PhD
Jean-Claude Desport, MD, PhD
Pierre Jésus, MD, PhD
Publication date
01-02-2021
Publisher
Springer US
Keyword
Stroke
Published in
Dysphagia / Issue 1/2021
Print ISSN: 0179-051X
Electronic ISSN: 1432-0460
DOI
https://doi.org/10.1007/s00455-020-10111-4

Other articles of this Issue 1/2021

Dysphagia 1/2021 Go to the issue

Original Article

Gastrostomy in Patients with Previous Abdominal Surgery: A Comparative Study Between the Laparoscopy-Assisted Introducer Percutaneous Endoscopic Gastrostomy Versus Open Gastrostomy in Advanced Esophageal Cancer

Original Article

Relationship Between Dysphagia and Sarcopenia with Comprehensive Geriatric Evaluation

Original Article

MRI Assessment of Swallow Muscle Activation with the Swallow Exercise Aid and with Conventional Exercises in Healthy Volunteers: An Explorative Biomechanical Study

Original Article

Measuring Vallecular Volume on Flexible Endoscopic Evaluation of Swallowing: A Proof of Concept Study

Original Article

Swallow Safety is Determined by Bolus Volume During Infant Feeding in an Animal Model

Original Article

Biomechanical Biomarkers of Tongue Impairment During Swallowing in Persons Diagnosed with Amyotrophic Lateral Sclerosis