Assessment of diabetes as a risk factor for neurogenic dysphagia confirmed by FEES examination in post-CVA patients

Abstract

Introduction Diabetes mellitus (DM) is an independent factor for the occurrence of neurogenic dysphagia following an acute cerebrovascular accident in the form of a stroke. This study assesses the role of DM as a risk factor for post-stroke dysphagia (PSD), confirmed by the fiberoptic endoscopic examination of swallowing (FEES) with particular emphasis on silent aspiration (SA) as a high risk factor of aspiration pneumonia (AP). Aim The aim of the study is to assess the role of DM as a risk factor for PSD. Material and methods Statistical analysis was performed on the cohort of 81 post-cerebrovascular-accident patients hospitalized in the neurological rehabilitation department. DM was diagnosed in more than one third of the cohort (35.8%). After the FEES examination, which was assessed in the penetration–aspiration scale (PAS), an analysis of DM incidence was performed in patients with diagnosed pharyngeal dysphagia of moderate degree (PAS 3–6) and severe degree (PAS 7–8). Results and discussion The incidence of DM in patients with moderate dysphagia was lower than in the cohort. The incidence of DM in patients with severe dysphagia (aspiration) was comparable to the percentage in the cohort. Although diabetes was twice as frequent among patients with aspiration than among those with mild dysphagia (24% vs. 12%), the odds ratio (OR) of the diabetes incidence in these groups was not statistically significant. Conclusions Although DM is an independent factor for PSD occurrence after cerebrovascular accident in the form of a stroke and a potential factor for lower cranial nerve neuropathy, no correlation between DM and PSD was found.