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After a stroke some people have difficulty swallowing (dysphagia). This means that food and drink can go down the wrong way into the lungs instead of the stomach, and can cause a serious chest infection known as Stroke Associated Pneumonia (SAP).

SAP is one of the most common post stroke infections, affecting 14% of patients, and is associated with an increased risk of death in hospital, prolonged hospital stay, and associated healthcare costs.

A new systematic review of the evidence has been published in the journal Cerebrovascular Diseases. It reviewed previous studies into the screening, assessment and management of pneumonia during the early (acute) stage of stroke and suggests that:

  • there is variation in the assessment and management of dysphagia in the acute stage of stroke.
  • there is increasing evidence that early dysphagia screening and a specialist swallow assessment by a speech and language pathologist (SLP) may reduce the risk of SAP.
  • other factors could potentially influence how frequently SAP happens in the acute stage of stroke.

Twelve studies of 87,824 patients were included in the systematic review.

The authors suggest that further research is required to investigate links between many potential factors and dysphagia patients developing SAP. This could improve our understanding of their impact during the first 72 hours of a stroke patient’s admission to hospital and may improve their outcomes.


This systematic review was funded through a Stroke Association Postgraduate Fellowship (TSA PGF 2017-03) awarded to lead author Sabrina Eltringham, Sheffield Hallam University.