Influence of Swallowing Function, Aphasia and High-Level Language Impairment on Discharge Destination Acutely Post-Thrombectomy.

Abstract

Purpose: This study aimed to describe the incidence of aphasia, high-level language impairment, and swallowing impairment in patients post-stroke treated with mechanical thrombectomy (MT) and to identify predictors of impairment and discharge destination.

Method: This retrospective study examined impairments diagnosed by a speech-language pathologist in patients post-MT during their admission to the acute stroke unit. Multivariate logistic regression was used to determine the independent predictors of impairments and discharge to inpatient rehabilitation.

Results: Language impairment was present in 66.4% (n = 249/375; n = 133 aphasia and n = 116 high-level impairment) and swallowing impairment in 59.1% (n = 238/403) of the patients. National Institute of Health Stroke Scale scores 24-hr post-MT were predictive of language (odds ratio [OR] = 1.09, 95% confidence interval [CI; 1.02, 1.16], p = .011) and swallowing (OR = 1.41, 95% CI [1.26, 1.58], p < .001) impairments. The occlusion site and medical complications post-MT were independently predictive of language and swallowing impairments, respectively. Diagnosed language impairment was a strong predictor of discharge for inpatient rehabilitation (OR = 4.77, 95% CI [1.60, 14.22], p = .005).

Conclusions: Swallowing and language impairments, such as aphasia or high-level impairment, in isolation and in combination with other demographic and clinical variables, significantly influence the discharge trajectory of patients acutely post-MT. This information is vital for clinicians who need to prognosticate and plan rehabilitative care.

Supplemental material: https://doi.org/10.23641/asha.30066892.