Disfagia

Factors related to swallowing prognosis in patients with acute ischemic stroke at a specialized institution in Medellín, Colombia. Factores asociados con el pronóstico deglutorio en pacientes con accidente cerebrovascular isquémico agudo en una institución especializada en Medellín, Colombia.

Objetive: To analyze the factors associated with swallowing prognosis among individuals with acute ischemic stroke who received treatment at a specialized neurology institution in Medellín, Colombia, in 2020.

Methods: This registry-based retrospective cohort study evaluated clinical factors influencing dysphagia, employing parametric survival models for interval-censored data.

Results: 270 patients were included, 52.2% female, with a mean age of 68.7 years (SD 14.4), with a mean follow-up of 4.91 days. The median survival time was 4.1 days (95% CI 3.7-4.6), with a cumulative seven-day survival rate of 22.72%. Main variables associated with dysphagia were TOAST small vessel occlusion (TR = 0.57, 95%CI 0.39-0.84) and large vessel atherosclerosis (TR=0.66, 95%CI 0.46-0.99), NIHSS severe (TR = 0.30, 95%CI 0.17-0.53), moderate (TR = 0.38, 95%CI 0.22-0.68), and mild to moderate scores (TR = 0.52, 95%CI 0.32-0.86), history of Parkinson’s disease (TR = 0.50, 95%CI 0.27-0.96) and older age (p = 0.043).

Conclusion: These findings have implications for developing a risk score to aid decision-making.

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Palabras clave: Accidente Cerebrovascular Isquémico, Deglución, Disfagia, Pronóstico,

Keywords: Dysphagia, ischemic stroke, Prognosis, Swallowing,

Impacto de los trastornos motores del habla y deglución sobre la calidad de vida de personas con enfermedad de Parkinson: una revisión sistemática de la literatura. Impact of motor speech and swallowing disorders in quality of life of people with Parkinson’s disease: a systematic review of the literature

Parkinson’s disease (PD) is the second most common neurodegenerative disorder after Alzheimer’s-type dementia. It is known that these types of diseases cause a significant decline in the quality of life of the people who suffer from them and in their next of kin. Understanding the physical and psychosocial effects of neurodegenerative diseases contributes to clinical decisionmaking. It is for the above mentioned that the present study aims to examine the current evidence regarding the direct impact that phonoaaudiological disorders of motor origin generate on the quality of life in people with PD. A systematic review of the literature was carried out. The articles were searched in the following databases: PUBMED, SCIELO and WOS, during the months of June and July of the year 2020, constituting a sample of 12 works, with a maximum age of 10 years. The analysed publications mainly describe the aspects of quality of life that are affected in people with PD, who suffer dysphagia or dysarthria, all this through the application of different questionnaires which evaluate different aspects of this concept. The results of the review show the importance of considering within the intervention process the component of quality of life in people with E.P, since the scores obtained according to the instruments applied indicate a decrease of this component and even more with the progress of the disease, which translates into worse quality of life related to food and speech.