Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu, Taiwan.
Department of Medical Imaging, National Taiwan University Hospital, Taipei, Taiwan.
Eur J Radiol. 2023 Aug;165:110939. doi: 10.1016/j.ejrad.2023.110939. Epub 2023 Jun 20.
Post-stroke dysphagia (PSD) is a common sequela of stroke. Given the association between dysphagia and sarcopenia, we aimed to investigate the association between PSD and temporal muscle thickness (TMT) and masseter muscle thickness (MMT) following endovascular thrombectomy (EVT) in patients with large-vessel occlusion (LVO).
This retrospective cohort study included hospitalized patients with LVO stroke who underwent EVT between January 1, 2018, and October 31, 2022. TMT and MMT were measured using brain computed tomography (CT) angiography. The correlation between relevant clinicodemographic factors and both TMT and MMT was examined. The relationship between each of two parameters (TMT and MMT) and PSD, which was defined as the retention of the nasogastric (NG) tube at 4 and 12 weeks, was evaluated in adjusted logistic regression models.
Among the 148 participants, the mean TMT and MMT was 5.9 ± 1.6 and 11.2 ± 2.3 mm, respectively. Lower age, male sex, higher body mass index (BMI), higher albumin levels, and a lower initial National Institute of Health Stroke Scale (NIHSS) score were associated with higher TMT and MMT (p < 0.05). In the logistic regression analysis adjusted for age, sex, BMI, serum albumin, and NIHSS score, lower TMT and MMT significantly correlated with PSD at weeks 4 and 12 (p < 0.001).
TMT and MMT are associated with age, sex, BMI, albumin, and the initial NIHSS score. Both TMT and MMT are independent indicators of post-EVT PSD in stroke patients and serve as reliable predictors of NG removal.
卒中后吞咽困难（PSD）是卒中的常见后遗症。鉴于吞咽困难与肌肉减少症之间存在关联，我们旨在研究血管内血栓切除术（EVT）后大血管闭塞（LVO）患者 PSD 与颞肌厚度（TMT）和咬肌厚度（MMT）之间的关系。
这项回顾性队列研究纳入了 2018 年 1 月 1 日至 2022 年 10 月 31 日期间接受 EVT 的 LVO 卒中住院患者。使用脑 CT 血管造影（CTA）测量 TMT 和 MMT。检查了相关临床和人口统计学因素与 TMT 和 MMT 的相关性。在调整后的逻辑回归模型中评估了两个参数（TMT 和 MMT）中的每一个与 PSD（定义为 4 周和 12 周时保留鼻胃管）之间的关系。
在 148 名参与者中，TMT 和 MMT 的平均值分别为 5.9±1.6 和 11.2±2.3mm。较低的年龄、男性、较高的体重指数（BMI）、较高的白蛋白水平和较低的初始国立卫生研究院卒中量表（NIHSS）评分与较高的 TMT 和 MMT 相关（p<0.05）。在调整年龄、性别、BMI、血清白蛋白和 NIHSS 评分的逻辑回归分析中，较低的 TMT 和 MMT 与第 4 周和第 12 周的 PSD 显著相关（p<0.001）。
TMT 和 MMT 与年龄、性别、BMI、白蛋白和初始 NIHSS 评分相关。TMT 和 MMT 均是卒中患者 EVT 后 PSD 的独立指标，是 NG 移除的可靠预测指标。
