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

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.