This is a retrospective study of 378 consecutive
stroke patients who were referred between June 1994 and June 1997 for videofluorographic study of oropharyngeal swallow. Patients who had
radiation therapy,
brain tumor, brain surgery, head and/or
spinal cord trauma, oral-
pharyngeal disease or surgery, or other neurologic diseases in addition to the
stroke were excluded from the study. Patients were assigned to two groups: one with
pneumonia and one without
pneumonia. One hundred one patients were included in the
pneumonia group, and 277 patients were included in the nonpneumonia group. Within the
pneumonia group, patients were assigned to an acute
pneumonia group (
pneumonia within 6 months poststroke) and a chronic
pneumonia group (
pneumonia more than 6 months poststroke). Variables examined in the study included patients' medical history and the findings from the videofluorographic studies. Pearson chi-square analysis was used to identify those variables that were significantly different between the
pneumonia and nonpneumonia patient groups and between the acute and chronic
pneumonia groups. Results showed that
stroke patients who developed
pneumonia had a significantly higher incidence of multiple-location and unspecified lesion
strokes, chronic airway disease in their medical history, and aspiration during the videofluorographic studies when compared with patients who did not develop
pneumonia. Within the
pneumonia group, the acute
pneumonia group was found to have a significantly higher incidence of
hypertension and diabetes in their medical history and a significantly higher incidence of aspiration and reduced laryngeal elevation during the videofluorographic studies. Between 48% and 55% of all
stroke patients in the study aspirated. Patients who suffered multiple
strokes,
brainstem stroke, or subcortical
stroke had the greatest frequency of aspiration.