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Pneumonia is the most common medical complication after stroke, with an estimated incidence ranging from 5% to 26%. It has been reported to increase long-term stroke mortality. Factors associated with poststroke pneumonia are older age, dysphagia, male gender, stroke severity, chronic obstructive lung disease, and coronary artery disease. Patients receiving high levels of organized stroke care have a lower risk for mortality after pneumonia. Several studies have suggested that dysphagia, which can occur in about half of patients after stroke, is strongly associated with this complication.
In this prospective, cluster-randomized, open-label, controlled trial, 48 stroke units were randomly assigned to two treatment groups: 24 to prophylactic a…