Dysphagia Bedside Screening in Acute Hemorrhagic Stroke: A Cross-sectional Study Investigating the Applicability of the Gugging Swallowing Screen

Background: Stroke remains a leading cause of morbidity and mortality worldwide, with acute hemorrhagic stroke (AHS) carrying a high risk of complications such as dysphagia. Swallowing dysfunction occurs early after stroke and predisposes to aspiration pneumonia, malnutrition, and poor outcomes. Despite its clinical importance, dysphagia in AHS is underexplored compared to ischemic stroke, highlighting the need for standardized bedside screening. Aims and Objectives: The present study aimed to estimate the prevalence of dysphagia in AHS patients and evaluate the applicability of the Gugging Swallowing Screen (GUSS) for early detection of dysphagia. Materials and Methods: This prospective cross-sectional study (May 2023–May 2025) at Jawaharlal Nehru Medical College, Aligarh, included 166 AHS patients admitted within 72 h of the incident. Excluding preexisting dysphagia and ischemic stroke, participants underwent the GUSS assessment. The study participants were divided into 83 participants each, and GUSS was applied to only group A. Statistical analysis evaluated associations between dysphagia, aspiration pneumonia, hospital stay, and mortality between these two groups to determine the clinical relevance of GUSS in early detection. Results: Overall, dysphagia prevalence was 65.6% among the screened patients. Aspiration pneumonia was significantly higher among those with low GUSS scores ( P < 0.001). Patients with impaired swallowing had longer hospital stays, and mortality was markedly higher in those with poor swallowing function (34.9% vs. 18.1%, P = 0.014). GUSS effectively stratified aspiration risk and predicted adverse outcomes. Conclusion: Dysphagia is common in AHS, increasing the risks of pneumonia, prolonged hospitalization, and mortality. GUSS enables early detection and timely intervention, improving outcomes. Routine integration of GUSS into stroke care protocols is strongly recommended.