THE NATURAL-HISTORY AND CLINICAL CONSEQUENCES OF ASPIRATION IN ACUTE STROKE

Sixty consecutive patients admitted to a teaching hospital with acute stroke were studied prospectively for 3 months to define the natural h istory and consequences of lung aspiration. Using videofluoroscopy, as piration was identified in 25 patients (42%) within 72 h of stroke ons et, and had resolved in all but three patients (8%) after 3 months. It was closely related to the presence of dysphagia, which itself resolv ed within 2 weeks in all but the persistent aspirators. Lower respirat ory tract infection (LRTI) was more common in aspirating patients (68% ) than non-aspirators (6%). The use of intravenous fluids without oral intake did not appear to prevent LRTI in aspirating patients who were also dysphagic, Pneumonia occurred after 2 weeks in the three patient s subsequently found to aspirate persistently. Aspiration is a transie nt phenomenon in most cases of acute stroke; it is associated with a h igh incidence of LRTI, but mortality in this series was not significan tly associated either with respiratory tract infection or aspiration i tself.