Inserm, U1094, Tropical Neuroepidemiology, 2 rue du Dr Marcland, 87025, Limoges Cedex, France.
UMR_S 1094, Tropical Neuroepidemiology, Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, Univ. Limoges, 87000, Limoges, France.
Dysphagia. 2021 Feb;36(1):85-95. doi: 10.1007/s00455-020-10111-4. Epub 2020 Apr 17.
Stroke frequently causes deglutition disorders, leading to a decline in nutritional status and complications, and increasing mortality. Sub-Saharan data are scarce. The objectives of this study were to assess complications and mortality among hospitalized patients in Burkina Faso during the first two weeks after stroke, and to investigate associated factors. Patients with stroke were followed prospectively in Ouagadougou and Bobo-Dioulasso hospitals. Deglutition disorders and nutritional parameters were assessed at baseline (D0) and on Days 8 (D8) and 14 (D14). Complications and mortality were recorded up to D14. Factors associated with complications and mortality were investigated using multivariate analysis. Of the 222 patients included, 81.5% developed at least one complication, and mortality was 17.1%. At D0, D8, and D14, the rate of deglutition disorders was 37.4%, 28.4%, and 15.8%, respectively, and that of undernourishment 25.2%, 29.4%, and 31.0%, respectively. In multivariate analysis, only the presence of deglutition disorders was a risk factor for developing at least one complication (OR = 5.47, 95% CI 1.81-16.51). Factors predicting death were the presence of deglutition disorders at D0 (OR = 7.19, 95% CI 3.10-16.66), and at least one seizure during follow-up (OR = 3.69, 95% CI 1.63-8.36). After stroke, the rates of complications, death, and undernourishment were high compared to Western countries. Prevention and management of deglutition disorders, and specific follow-up of patients with seizures could reduce post-stroke mortality.
中风常导致吞咽障碍,导致营养状况下降和并发症增加,死亡率升高。撒哈拉以南非洲的数据很少。本研究的目的是评估布基纳法索住院脑卒中患者在中风后两周内的并发症和死亡率,并探讨相关因素。在瓦加杜古和博博迪乌拉索医院对中风患者进行前瞻性随访。在基线(D0)和第 8 天(D8)和第 14 天(D14)评估吞咽障碍和营养参数。记录至 D14 的并发症和死亡率。使用多变量分析探讨与并发症和死亡率相关的因素。在 222 名患者中,81.5%至少发生一种并发症,死亡率为 17.1%。在 D0、D8 和 D14,吞咽障碍的发生率分别为 37.4%、28.4%和 15.8%,营养不良的发生率分别为 25.2%、29.4%和 31.0%。多变量分析表明,只有存在吞咽障碍是发生至少一种并发症的危险因素(OR=5.47,95%CI 1.81-16.51)。预测死亡的因素是 D0 时存在吞咽障碍(OR=7.19,95%CI 3.10-16.66)和随访期间至少有一次发作(OR=3.69,95%CI 1.63-8.36)。与西方国家相比,中风后并发症、死亡和营养不良的发生率较高。预防和管理吞咽障碍,以及对有癫痫发作的患者进行特定随访,可以降低中风后的死亡率。