{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,10]],"date-time":"2026-11-10T13:31:37Z","timestamp":1794317497670,"version":"4.9.0"},"reference-count":50,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"12","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[2005,12]]},"abstract":"<jats:p>\n                    <jats:bold>\n                      <jats:italic>Objective\u2014<\/jats:italic>\n                    <\/jats:bold>\n                    To determine the incidence of dysphagia and associated pulmonary compromise in stroke patients through a systematic review of the published literature.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>\n                      <jats:italic>Methods\u2014<\/jats:italic>\n                    <\/jats:bold>\n                    Databases were searched (1966 through May 2005) using terms \u201ccerebrovascular disorders,\u201d \u201cdeglutition disorders,\u201d and limited to \u201chumans\u201d for original articles addressing the frequency of dysphagia or pneumonia. Data sources included Medline, Embase, Pascal, relevant Internet addresses, and extensive hand searching of bibliographies of identified articles. Selected articles were reviewed for quality, diagnostic methods, and patient characteristics. Comparisons were made of reported dysphagia and pneumonia frequencies. The relative risks (RRs) of developing pneumonia were calculated in patients with dysphagia and confirmed aspiration.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>\n                      <jats:italic>Results\u2014<\/jats:italic>\n                    <\/jats:bold>\n                    Of the 277 sources identified, 104 were original, peer-reviewed articles that focused on adult stroke patients with dysphagia. Of these, 24 articles met inclusion criteria and were evaluated. The reported incidence of dysphagia was lowest using cursory screening techniques (37% to 45%), higher using clinical testing (51% to 55%), and highest using instrumental testing (64% to 78%). Dysphagia tends to be lower after hemispheric stroke and remains prominent in the rehabilitation brain stem stroke. There is increased risk for pneumonia in patients with dysphagia (RR, 3.17; 95% CI, 2.07, 4.87) and an even greater risk in patients with aspiration (RR, 11.56; 95% CI, 3.36, 39.77).\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>\n                      <jats:italic>Conclusions\u2014<\/jats:italic>\n                    <\/jats:bold>\n                    The high incidence for dysphagia and pneumonia is a consistent finding with stroke patients. The pneumonia risk is greatest in stroke patients with aspiration. These findings will be valuable in the design of future dysphagia research.\n                  <\/jats:p>","DOI":"10.1161\/01.str.0000190056.76543.eb","type":"journal-article","created":{"date-parts":[[2005,11,3]],"date-time":"2005-11-03T20:49:50Z","timestamp":1131050990000},"page":"2756-2763","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1749,"title":["Dysphagia After Stroke"],"prefix":"10.1161","volume":"36","author":[{"given":"Rosemary","family":"Martino","sequence":"first","affiliation":[{"name":"From the Graduate Department of Speech Language Pathology (R.M.), University of Toronto, Ontario, Canada; Toronto Western Research Institute (R.M., N.D.), University Health Network, Ontario, Canada; Department of Medicine (N.D.), University of Toronto, Ontario, Canada; Department of Physical Medicine and Rehabilitation (N.F., S.B., R.T.), St. Joseph\u2019s Health Care London, Parkwood Hospital, Ontario, Canada; and Department of Epidemiology and Biostatistics (M.S.), University of Western Ontario, London..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Norine","family":"Foley","sequence":"additional","affiliation":[{"name":"From the Graduate Department of Speech Language Pathology (R.M.), University of Toronto, Ontario, Canada; Toronto Western Research Institute (R.M., N.D.), University Health Network, Ontario, Canada; Department of Medicine (N.D.), University of Toronto, Ontario, Canada; Department of Physical Medicine and Rehabilitation (N.F., S.B., R.T.), St. Joseph\u2019s Health Care London, Parkwood Hospital, Ontario, Canada; and Department of Epidemiology and Biostatistics (M.S.), University of Western Ontario, London..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanjit","family":"Bhogal","sequence":"additional","affiliation":[{"name":"From the Graduate Department of Speech Language Pathology (R.M.), University of Toronto, Ontario, Canada; Toronto Western Research Institute (R.M., N.D.), University Health Network, Ontario, Canada; Department of Medicine (N.D.), University of Toronto, Ontario, Canada; Department of Physical Medicine and Rehabilitation (N.F., S.B., R.T.), St. Joseph\u2019s Health Care London, Parkwood Hospital, Ontario, Canada; and Department of Epidemiology and Biostatistics (M.S.), University of Western Ontario, London..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas","family":"Diamant","sequence":"additional","affiliation":[{"name":"From the Graduate Department of Speech Language Pathology (R.M.), University of Toronto, Ontario, Canada; Toronto Western Research Institute (R.M., N.D.), University Health Network, Ontario, Canada; Department of Medicine (N.D.), University of Toronto, Ontario, Canada; Department of Physical Medicine and Rehabilitation (N.F., S.B., R.T.), St. Joseph\u2019s Health Care London, Parkwood Hospital, Ontario, Canada; and Department of Epidemiology and Biostatistics (M.S.), University of Western Ontario, London..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Speechley","sequence":"additional","affiliation":[{"name":"From the Graduate Department of Speech Language Pathology (R.M.), University of Toronto, Ontario, Canada; Toronto Western Research Institute (R.M., N.D.), University Health Network, Ontario, Canada; Department of Medicine (N.D.), University of Toronto, Ontario, Canada; Department of Physical Medicine and Rehabilitation (N.F., S.B., R.T.), St. Joseph\u2019s Health Care London, Parkwood Hospital, Ontario, Canada; and Department of Epidemiology and Biostatistics (M.S.), University of Western Ontario, London..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Teasell","sequence":"additional","affiliation":[{"name":"From the Graduate Department of Speech Language Pathology (R.M.), University of Toronto, Ontario, Canada; Toronto Western Research Institute (R.M., N.D.), University Health Network, Ontario, Canada; Department of Medicine (N.D.), University of Toronto, Ontario, Canada; Department of Physical Medicine and Rehabilitation (N.F., S.B., R.T.), St. Joseph\u2019s Health Care London, Parkwood Hospital, Ontario, Canada; and Department of Epidemiology and Biostatistics (M.S.), University of Western Ontario, London..."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_1_1_2","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.52.2.236"},{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/00002060-200003000-00010"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.124.1.328"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1742-1241.2001.tb10970.x"},{"key":"e_1_3_1_5_2","first-page":"19","year":"2000","unstructured":"Martino R, Pron G, Diamant NE. Screening for oropharyngeal dysphagia in stroke: insufficient evidence for guidelines. Dysphagia. 2000: 19\u201330.","journal-title":"Dysphagia"},{"key":"e_1_3_1_6_2","doi-asserted-by":"publisher","DOI":"10.1002\/1531-8249(199909)46:3<281::AID-ANA2>3.0.CO;2-L"},{"key":"e_1_3_1_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/PL00009592"},{"key":"e_1_3_1_8_2","first-page":"372","volume":"66","year":"1985","unstructured":"Veis SL, Logemann JA. Swallowing disorders in persons with cerebrovascular accident. Arch Phys Med Rehabil. 1985; 66: 372\u2013375.","journal-title":"Arch Phys Med Rehabil"},{"key":"e_1_3_1_9_2","doi-asserted-by":"publisher","DOI":"10.1161\/str.31.6.1370"},{"key":"e_1_3_1_10_2","doi-asserted-by":"publisher","DOI":"10.1053\/gast.2001.26291"},{"key":"e_1_3_1_11_2","doi-asserted-by":"publisher","DOI":"10.1159\/000071127"},{"key":"e_1_3_1_12_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF00301913"},{"key":"e_1_3_1_13_2","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/55.11.M634"},{"key":"e_1_3_1_14_2","unstructured":"Martino R Meissner-Fishbein B Saville D Barton D Kerry V Kodama S Lbas-Weber M McVilltie A Mintz T Tamas I. Preferred practice guidelines for dysphagia. Quality Improvement: Preferred Practice Guidelines. 2000. Available at: http:\/\/www.caslpo.com\/english_site\/DysphagiaDocument. pdf. Accessed June 30 2004."},{"key":"e_1_3_1_15_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF01354535"},{"key":"e_1_3_1_16_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00455-004-0004-7"},{"key":"e_1_3_1_17_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-2008-1040990"},{"key":"e_1_3_1_18_2","unstructured":"Sackett DL Haynes RB Guyatt GH Tugwell P. Clinical Epidemiology: A Basic Science for Clinical Medicine. Boston Mass: Little Brown and Company; 1991."},{"key":"e_1_3_1_19_2","unstructured":"Review manager 4.2. Available at: http:\/\/www.cc-ims.net\/RevMan. Accessed June 14 2004."},{"key":"e_1_3_1_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-9993(96)90012-X"},{"key":"e_1_3_1_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-9993(99)90140-5"},{"key":"e_1_3_1_22_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF02406275"},{"key":"e_1_3_1_23_2","doi-asserted-by":"publisher","DOI":"10.1097\/01376517-200408000-00006"},{"key":"e_1_3_1_24_2","first-page":"603","volume":"6","year":"2004","unstructured":"Greenberg E, Treger J, Ring H. Post-stroke follow-up in a rehabilitation center outpatient clinic. Isr Med Assoc J. 2004; 6: 603\u2013606.","journal-title":"Isr Med Assoc J"},{"key":"e_1_3_1_25_2","doi-asserted-by":"publisher","DOI":"10.1007\/PL00009547"},{"key":"e_1_3_1_26_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF02412640"},{"key":"e_1_3_1_27_2","doi-asserted-by":"publisher","DOI":"10.1161\/str.25.2.8303744"},{"key":"e_1_3_1_28_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.str.0000068410.07397.d7"},{"key":"e_1_3_1_29_2","doi-asserted-by":"publisher","DOI":"10.1007\/PL00009535"},{"key":"e_1_3_1_30_2","doi-asserted-by":"publisher","DOI":"10.1093\/qjmed\/91.12.829"},{"key":"e_1_3_1_31_2","first-page":"825","volume":"86","year":"1993","unstructured":"Kidd D, Lawson J, Nesbitt R, MacMahon J. Aspiration in acute stroke: A clinical study with videofluoroscopy. QJM. 1993; 86: 825\u2013829.","journal-title":"QJM"},{"key":"e_1_3_1_32_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-9993(95)80121-9"},{"key":"e_1_3_1_33_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0404.1987.tb03543.x"},{"key":"e_1_3_1_34_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-9993(98)90200-3"},{"key":"e_1_3_1_35_2","doi-asserted-by":"publisher","DOI":"10.1111\/jon19999291"},{"key":"e_1_3_1_36_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(97)02068-0"},{"key":"e_1_3_1_37_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0016-5085(98)70081-2"},{"key":"e_1_3_1_38_2","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.57.4.478"},{"key":"e_1_3_1_39_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00455-003-0032-8"},{"key":"e_1_3_1_40_2","doi-asserted-by":"publisher","DOI":"10.1590\/S0004-282X2004000300023"},{"key":"e_1_3_1_41_2","doi-asserted-by":"crossref","first-page":"1284","DOI":"10.1016\/0003-9993(94)90274-7","volume":"75","year":"1994","unstructured":"DePippo KL, Holas MA, Reding MJ. The burke dysphagia screening test: validation of its use in patients with stroke. Arch Phys Med Rehabil. 1994; 75: 1284\u20131286.","journal-title":"Arch Phys Med Rehabil"},{"key":"e_1_3_1_42_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.295.6595.411"},{"key":"e_1_3_1_43_2","doi-asserted-by":"publisher","DOI":"10.3109\/09638289609166040"},{"key":"e_1_3_1_44_2","first-page":"409","volume":"88","year":"1995","unstructured":"Kidd D, Lawson J, Nesbitt R, MacMahon J. The natural history and clinical consequences of aspiration in acute stroke. QJM. 1995; 88: 409\u2013413.","journal-title":"QJM"},{"key":"e_1_3_1_45_2","doi-asserted-by":"publisher","DOI":"10.1007\/s004550000038"},{"key":"e_1_3_1_46_2","doi-asserted-by":"publisher","DOI":"10.1161\/str.30.4.744"},{"key":"e_1_3_1_47_2","doi-asserted-by":"publisher","DOI":"10.1161\/str.27.7.1200"},{"key":"e_1_3_1_48_2","doi-asserted-by":"crossref","first-page":"759","DOI":"10.33588\/rn.27159.98077","volume":"27","year":"1998","unstructured":"Sala R, Munto MJ, de la Calle J, Preciado I, Miralles T, Cortes A, Molla R, Alcaide M. Swallowing changes in cerebrovascular accidents: incidence, natural history, and repercussions on the nutritional status, morbidity, and mortality. Rev Neurol. 1998; 27: 759\u2013766.","journal-title":"Rev Neurol"},{"key":"e_1_3_1_49_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00455-001-0110-8"},{"key":"e_1_3_1_50_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-9993(96)90167-7"}],"container-title":["Stroke"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/01.STR.0000190056.76543.eb","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,1,5]],"date-time":"2025-01-05T04:53:57Z","timestamp":1736052837000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/01.STR.0000190056.76543.eb"}},"subtitle":["Incidence, Diagnosis, and Pulmonary Complications"],"short-title":[],"issued":{"date-parts":[[2005,12]]},"references-count":50,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2005,12]]}},"alternative-id":["10.1161\/01.STR.0000190056.76543.eb"],"URL":"https:\/\/doi.org\/10.1161\/01.str.0000190056.76543.eb","relation":{},"ISSN":["0039-2499","1524-4628"],"issn-type":[{"value":"0039-2499","type":"print"},{"value":"1524-4628","type":"electronic"}],"subject":[],"published":{"date-parts":[[2005,12]]},"assertion":[{"value":"2005-07-19","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2005-09-02","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2005-11-03","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}