Route of feeding as a proxy for dysphagia ater stroke and the effect of transdermal glyceryl trinitrate: data from the efficacy of nitric oxide in stroke randomised controlled trial

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dc.contributor.authorWoodhouse, Lisa J.
dc.contributor.authorScutt, Polly.
dc.contributor.authorHamdy, Shaheen.
dc.contributor.authorSmithard, David G.
dc.contributor.authorCohen, David L.
dc.contributor.authorRoffe, Christine.
dc.contributor.authorBereczki, Daniel.
dc.contributor.authorBerge, Eivind.
dc.contributor.authorBladin, Christopher F.
dc.contributor.authorCaso, Valeria.
dc.contributor.authorChristensen, Hanne K.
dc.contributor.authorCollins, Rónán.
dc.contributor.authorCzlonkowska, Anna.
dc.contributor.authorSilva, Asita de.
dc.contributor.authorEtribi, Anwar.
dc.contributor.authorLaska, Ann-Charlotte.
dc.contributor.authorNtaios, George.
dc.contributor.authorOzturk, Serefnur.
dc.contributor.authorPhillips, Stephen J.
dc.contributor.authorPrasad, Kameshwar.
dc.contributor.authorSzatmari, Szabolcs.
dc.contributor.authorSprigg, Nikola.
dc.contributor.authorBath, Philip M.
dc.date.accessioned2020-03-26T19:55:33Z
dc.date.available2020-03-26T19:55:33Z
dc.date.issued2018
dc.departmentSelçuk Üniversitesi, Tıp Fakültesi, Dahili Tıp Bilimleri Bölümü.en_US
dc.description.abstractat day Post-stroke dysphagia is common, associated with poor outcome and often requires non-oral feeding/fluids. The relationship between route of feeding and outcome, as well as treatment with glyceryl trinitrate (GTN), was studied prospectively. The Efficacy of Nitric Oxide in Stroke (ENOS) trial assessed transdermal GTN (5 mg versus none for 7 days) in 4011 patients with acute stroke and high blood pressure. Feeding route (oral = normal or soft diet; non-oral = nasogastric tube, percutaneous endoscopic gastrostomy tube, parenteral fluids, no fluids) was assessed at baseline and day 7. The primary outcome was the modified Rankin Scale (mRS) measured 90. At baseline, 1331 (33.2%) patients had non-oral feeding, were older, had more severe stroke and more were female, than 2680 (66.8%) patients with oral feeding. By day 7, 756 patients had improved from non-oral to oral feeding, and 119 had deteriorated. Non-oral feeding at baseline was associated with more impairment at day 7 (Scandinavian Stroke Scale 29.0 versus 43.7; 2p < 0.001), and worse mRS (4.0 versus 2.7; 2p < 0.001) and death (23.6 versus 6.8%; 2p = 0.014) at day 90. Although GTN did not modify route of feeding overall, randomisation ae<currency>6 h of stroke was associated with a move to more oral feeding at day 7 (odds ratio = 0.61, 95% confidence intervals 0.38, 0.98; 2p = 0.040). As a proxy for dysphagia, non-oral feeding is present in 33% of patients with acute stroke and associated with more impairment, dependency and death. GTN moved feeding route towards oral intake if given very early after stroke.en_US
dc.description.sponsorshipMedical Research CouncilMedical Research Council UK (MRC) [G0501797]; Bupa Foundation; Medical Research CouncilMedical Research Council UK (MRC); Stroke Associationen_US
dc.description.sponsorshipThis work was supported by the Medical Research Council [grant number G0501797]. ENOS was funded by the Bupa Foundation and Medical Research Council, and supported by the Stroke Association. PMB is a Stroke Association Professor of Stroke Medicine, and a NIHR Senior Investigator. No GTN manufacturer was involved in the trial.en_US
dc.identifier.citationWoodhouse, L. J., Scutt, P., Hamdy, S., Smithard, D. G., Cohen, D. L., Roffe, C., Bereczki, D., Berge, E., Bladin, C. F., Caso, V., Christensen, H. K., Collins, R., Czlonkowska, A., Silva, A. D., Etribi, A., Laska, A. C., Ntaios, G., Ozturk, S., Phillips, S. J., Prasad, K., Szatmari, S., Sprigg, N., Bath, P. M. (2018). Route of Feeding as a Proxy for Dysphagia After Stroke and the Effect of Transdermal Glyceryl Trinitrate: Data from the Efficacy of Nitric Oxide in Stroke Randomised Controlled Trial. Translational Stroke Research, 9(2), 120-129.
dc.identifier.doi10.1007/s12975-017-0548-0en_US
dc.identifier.endpage129en_US
dc.identifier.issn1868-4483en_US
dc.identifier.issn1868-601Xen_US
dc.identifier.issue2en_US
dc.identifier.pmid28770403en_US
dc.identifier.scopusqualityQ1en_US
dc.identifier.startpage120en_US
dc.identifier.urihttps://dx.doi.org/10.1007/s12975-017-0548-0
dc.identifier.urihttps://hdl.handle.net/20.500.12395/36928
dc.identifier.volume9en_US
dc.identifier.wosWOS:000427517600005en_US
dc.identifier.wosqualityQ1en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.institutionauthorOzturk, Serefnur.
dc.language.isoenen_US
dc.publisherSPRINGERen_US
dc.relation.ispartofTRANSLATIONAL STROKE RESEARCHen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.selcuk20240510_oaigen_US
dc.subjectDysphagiaen_US
dc.subjectGlyceryl trinitrateen_US
dc.subjectOutcomeen_US
dc.subjectRandomised controlled trialen_US
dc.subjectStrokeen_US
dc.titleRoute of feeding as a proxy for dysphagia ater stroke and the effect of transdermal glyceryl trinitrate: data from the efficacy of nitric oxide in stroke randomised controlled trialen_US
dc.typeArticleen_US

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