Mao Lin, Wang Juehan, Li Yubo, Zheng JinJin, Fan Denghuang, Wei Shuang, Wu Xiaohong, Yang Xiaofeng, Wang Daming
Department of Rehabilitation Medicine, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Information and Electronic Engineering College, Zhejiang University School, Hangzhou, China.
Heliyon. 2024 Jan 17;10(2):e24582. doi: 10.1016/j.heliyon.2024.e24582. eCollection 2024 Jan 30.
Dysphagia is a common and clinically significant complication of ischemic stroke. The prevalence and risk factors for dysphagia may vary at different stages following an ischemic stroke.
This study included patients with acute and chronic ischemic stroke who were treated at the Department of Rehabilitation, First Affiliated Hospital, Zhejiang University School of Medicine from 2019 to 2022. Various demographic, clinical, and laboratory parameters were collected, and statistical analyses were performed to investigate their association with dysphagia.
Among the 399 ischemic stroke patients included in the study, 165 (41.4 %) experienced dysphagia, with 72 (38.7 %) in the acute phase and 93 (43.7 %) in the chronic phase. Univariate analysis revealed significant associations (p < 0.05) between dysphagia and factors such as pulmonary infection, aphasia, NIHSS score, ADL score, NLR score, lower extremity Brunnstrom's stages, and sit-to-stand balance. Multiple logistic regression analysis, after adjusting for confounding factors, identified the ADL score as an independent predictor of dysphagia. These findings were consistent across three time-windows: the acute phase, the chronic phase, and 180 days after stroke onset. Additionally, the lymphocyte count and pulmonary infection were identified as potential independent indicators.
This study investigated the prevalence and risk factors for dysphagia in ischemic stroke patients at different time-windows. A low ADL score (<40) may serve as a valuable and reliable predictor for poststroke dysphagia in clinical settings.
吞咽困难是缺血性卒中常见且具有临床意义的并发症。缺血性卒中后不同阶段吞咽困难的患病率和危险因素可能有所不同。
本研究纳入了2019年至2022年在浙江大学医学院附属第一医院康复科接受治疗的急性和慢性缺血性卒中患者。收集了各种人口统计学、临床和实验室参数，并进行统计分析以研究它们与吞咽困难的关联。
在纳入研究的399例缺血性卒中患者中，165例（41.4%）出现吞咽困难，其中急性期72例（38.7%），慢性期93例（43.7%）。单因素分析显示，吞咽困难与肺部感染、失语、美国国立卫生研究院卒中量表（NIHSS）评分、日常生活活动能力（ADL）评分、中性粒细胞与淋巴细胞比值（NLR）评分、下肢Brunnstrom分期以及从坐到站平衡等因素之间存在显著关联（p<0.05）。在调整混杂因素后，多因素logistic回归分析确定ADL评分是吞咽困难的独立预测因素。这些发现在三个时间窗（急性期、慢性期和卒中发作后180天）均一致。此外，淋巴细胞计数和肺部感染被确定为潜在的独立指标。
本研究调查了缺血性卒中患者在不同时间窗吞咽困难的患病率和危险因素。低ADL评分（<40）可能是临床环境中卒中后吞咽困难的一个有价值且可靠的预测指标。
