Effect of stroke location on the laryngeal cough reflex and pneumonia risk

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Effect of stroke location on the laryngeal cough reflex and pneumonia risk

Please use this identifier to cite or link to this item: http://dx.doi.org/10.1186/1745-9974-1-4

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dc.contributor.author Addington, W Robert
dc.contributor.author Stephens, Robert E
dc.contributor.author Widdicombe, John G
dc.contributor.author Rekab, Kamel
dc.date.accessioned 2012-08-29T15:29:26Z
dc.date.available 2012-08-29T15:29:26Z
dc.date.issued 2005-08-04
dc.identifier.citation Cough. 2005 Aug 04;1(1):4
dc.identifier.uri http://dx.doi.org/10.1186/1745-9974-1-4
dc.identifier.uri http://hdl.handle.net/10355/15062
dc.description.abstract Abstract Background The purpose of this study was to evaluate the risk of developing pneumonia in acute stroke patients comparing the early anatomical stroke location and laryngeal cough reflex (LCR) testing. Methods A prospective study of 818 consecutive acute stroke patients utilizing a reflex cough test (RCT), which assesses the neurological status of the LCR compared to magnetic resonance imaging or computerized tomography for stroke location and subsequent pneumonia outcome. Stroke diagnosis and stroke location were made by a neurologist and clinical radiologist, respectively; both were blinded to the RCT results. Results Brainstem (p-value < .007) and cerebral strokes (p-value < .005) correlated with the RCT results and pneumonia outcome. Of the 818 patients, 35 (4.3%) developed pneumonia. Of the 736 (90%) patients who had a normal RCT, 26 (3.5%) developed pneumonia, and of the 82 (10%) patients with an abnormal RCT, 9 (11%) developed pneumonia despite preventive interventions (p-value < .005). The RCT had no serious adverse events. Conclusion The RCT acted as a reflex hammer or percussor of the LCR and neurological airway protection and indicated pneumonia risk. Despite stroke location, patients may exhibit "brainstem shock," a global neurological condition involving a transient or permanent impairment of respiratory drive, reticular activating system or LCR. Recovery of these functions may indicate emergence from brainstem shock, and help predict morbidity and mortality outcome.
dc.title Effect of stroke location on the laryngeal cough reflex and pneumonia risk
dc.type Journal Article
dc.date.updated 2012-08-29T15:29:27Z
dc.description.version Peer Reviewed
dc.language.rfc3066 en
dc.rights.holder W Robert Addington et al.; licensee BioMed Central Ltd.


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