Clinical Outcomes Associated with Speech, Language and Swallowing Difficulties Post-Stroke – A Prospective Cohort Study

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dc.contributor.advisorSingh, Shajila
dc.contributor.authorKaylor, Stephanie Anne
dc.date.accessioned2023-03-29T06:55:00Z
dc.date.available2023-03-29T06:55:00Z
dc.date.issued2022
dc.date.updated2023-03-15T07:46:37Z
dc.description.abstractBackground: Due to a lack of prospective research in South Africa's Speech-Language Therapy (SLT) private healthcare sector, this prospective cohort study investigated associations between speech, language, and swallowing conditions (i.e. dysarthria, apraxia of speech, aphasia, dysphagia), risk factors, and outcomes post-stroke (i.e. length of hospital stay, degree of physical disability according to the Modified Rankin Scale [mRS], functional level of oral intake according to the Functional Oral Intake Scale [FOIS], dehydration, weight loss, aspiration pneumonia, mortality). Methods: Adults with a new incident of stroke without pre-existing speech, language or swallowing difficulties (N=68) were recruited. Convenience sampling was used to select participants. A prospective design was used to determine the incidence of speech, language, and swallowing conditions poststroke and association with outcomes from admission to discharge. Results: Co-occurring speech, language, and swallowing conditions frequently occurred post-stroke (88%). Participants who were referred to SLT greater than 24 hours post-admission (52.94%) stayed in hospital for a median of three days longer than those who were referred within 24 hours (p=.042). Dysphagia was significantly associated with moderate to severe physical disability. Dysphagia with aspiration was significantly associated with poor functional level of oral intake (i.e. altered consistency diets and enteral nutrition), at admission and at discharge (p<. 01). Dysphagia had a higher likelihood of mortality (OR=2.86) (p=.319). At discharge, aspiration pneumonia was significantly associated with severe physical disability (p< .01, r=0.70). Risk factors; poor oral hygiene (p=1.00), low level of consciousness (p=1.00), dependent for oral intake (p=.040), and enteral nutrition (p=.257); were not associated with aspiration pneumonia. Conclusion: In South Africa's private sector, cooccurring speech, language, and swallowing conditions commonly occurred post-stroke, and dysphagia was strongly associated with physical disability and poor functional level of oral intake. Length of hospital stay was increased by delayed SLT referrals.
dc.identifier.apacitationKaylor, S. A. (2022). <i>Clinical Outcomes Associated with Speech, Language and Swallowing Difficulties Post-Stroke – A Prospective Cohort Study</i>. (). ,Faculty of Health Sciences ,Division of Communication Sciences and Disorders. Retrieved from http://hdl.handle.net/11427/37539en_ZA
dc.identifier.chicagocitationKaylor, Stephanie Anne. <i>"Clinical Outcomes Associated with Speech, Language and Swallowing Difficulties Post-Stroke – A Prospective Cohort Study."</i> ., ,Faculty of Health Sciences ,Division of Communication Sciences and Disorders, 2022. http://hdl.handle.net/11427/37539en_ZA
dc.identifier.citationKaylor, S.A. 2022. Clinical Outcomes Associated with Speech, Language and Swallowing Difficulties Post-Stroke – A Prospective Cohort Study. . ,Faculty of Health Sciences ,Division of Communication Sciences and Disorders. http://hdl.handle.net/11427/37539en_ZA
dc.identifier.ris TY - Master Thesis AU - Kaylor, Stephanie Anne AB - Background: Due to a lack of prospective research in South Africa's Speech-Language Therapy (SLT) private healthcare sector, this prospective cohort study investigated associations between speech, language, and swallowing conditions (i.e. dysarthria, apraxia of speech, aphasia, dysphagia), risk factors, and outcomes post-stroke (i.e. length of hospital stay, degree of physical disability according to the Modified Rankin Scale [mRS], functional level of oral intake according to the Functional Oral Intake Scale [FOIS], dehydration, weight loss, aspiration pneumonia, mortality). Methods: Adults with a new incident of stroke without pre-existing speech, language or swallowing difficulties (N=68) were recruited. Convenience sampling was used to select participants. A prospective design was used to determine the incidence of speech, language, and swallowing conditions poststroke and association with outcomes from admission to discharge. Results: Co-occurring speech, language, and swallowing conditions frequently occurred post-stroke (88%). Participants who were referred to SLT greater than 24 hours post-admission (52.94%) stayed in hospital for a median of three days longer than those who were referred within 24 hours (p=.042). Dysphagia was significantly associated with moderate to severe physical disability. Dysphagia with aspiration was significantly associated with poor functional level of oral intake (i.e. altered consistency diets and enteral nutrition), at admission and at discharge (p<. 01). Dysphagia had a higher likelihood of mortality (OR=2.86) (p=.319). At discharge, aspiration pneumonia was significantly associated with severe physical disability (p< .01, r=0.70). Risk factors; poor oral hygiene (p=1.00), low level of consciousness (p=1.00), dependent for oral intake (p=.040), and enteral nutrition (p=.257); were not associated with aspiration pneumonia. Conclusion: In South Africa's private sector, cooccurring speech, language, and swallowing conditions commonly occurred post-stroke, and dysphagia was strongly associated with physical disability and poor functional level of oral intake. Length of hospital stay was increased by delayed SLT referrals. DA - 2022_ DB - OpenUCT DP - University of Cape Town KW - stroke KW - acute care KW - prospective cohort KW - South Africa KW - private sector KW - speech therapy KW - dysphagia KW - outcomes LK - https://open.uct.ac.za PY - 2022 T1 - Clinical Outcomes Associated with Speech, Language and Swallowing Difficulties Post-Stroke – A Prospective Cohort Study TI - Clinical Outcomes Associated with Speech, Language and Swallowing Difficulties Post-Stroke – A Prospective Cohort Study UR - http://hdl.handle.net/11427/37539 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/37539
dc.identifier.vancouvercitationKaylor SA. Clinical Outcomes Associated with Speech, Language and Swallowing Difficulties Post-Stroke – A Prospective Cohort Study. []. ,Faculty of Health Sciences ,Division of Communication Sciences and Disorders, 2022 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/37539en_ZA
dc.language.rfc3066eng
dc.publisher.departmentDivision of Communication Sciences and Disorders
dc.publisher.facultyFaculty of Health Sciences
dc.subjectstroke
dc.subjectacute care
dc.subjectprospective cohort
dc.subjectSouth Africa
dc.subjectprivate sector
dc.subjectspeech therapy
dc.subjectdysphagia
dc.subjectoutcomes
dc.titleClinical Outcomes Associated with Speech, Language and Swallowing Difficulties Post-Stroke – A Prospective Cohort Study
dc.typeMaster Thesis
dc.type.qualificationlevelMasters
dc.type.qualificationlevelMSc
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