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中风后吞咽困难的患病率及危险因素:一项荟萃分析。

Prevalence and Risk Factors of Poststroke Dysphagia: A Meta-Analysis.

作者信息

Gu Haiyan, Ren Dan

机构信息

Intensive Care Rehabilitation Department, Ningbo Rehabilitation Hospital, Ningbo, China.

出版信息

Cerebrovasc Dis. 2025;54(2):236-259. doi: 10.1159/000538218. Epub 2024 Apr 20.

Abstract

INTRODUCTION

In patients with stroke, poststroke dysphagia (PSD) is a common complication that plays an important role in morbidity and mortality. The aim of this paper was to assess the prevalence and risk factors of PSD using a systemic review and meta-analysis.

METHODS

PubMed, Embase, Cochrane Library, and Web of Science databases were systematically searched for potentially eligible studies published until September 2023. Further, the pooled incidence and risk factors for PSD were determined using a random-effects model. Overall, 58 studies involving 37,404 patients with acute stroke were selected for the meta-analysis.

RESULTS

The pooled incidence of PSD in patients with acute stroke was 42% (95% confidence interval [CI]: 36-48%), which is the highest in South America (47%) and lowest in Asia (37%). Notably, older age (odds ratio [OR]: 2.13; 95% CI: 1.53-2.97; p < 0.001), hypertension (OR: 1.23; 95% CI: 1.06-1.44; p = 0.007), diabetes mellitus (OR: 1.22; 95% CI: 1.04-1.44; p = 0.014), stroke history (OR: 1.26; 95% CI: 1.04-1.53; p = 0.019), and atrial fibrillation (OR: 1.58; 95% CI: 1.02-2.44; p = 0.039) were found to be associated with an increased risk of PSD. Conversely, sex differences, smoking, alcoholism, obesity, hyperlipidemia, ischemic heart disease, stroke type, and the hemisphere affected were not associated with the risk of PSD.

CONCLUSION

The abstract reports the prevalence of PSD in patients with acute stroke and identified potential risk factors for PSD, including older age, hypertension, diabetes mellitus, stroke history, and atrial fibrillation.

摘要

引言

在中风患者中,中风后吞咽困难(PSD)是一种常见并发症,在发病率和死亡率方面起着重要作用。本文旨在通过系统评价和荟萃分析评估PSD的患病率及危险因素。

方法

系统检索了PubMed、Embase、Cochrane图书馆和Web of Science数据库,以查找截至2023年9月发表的潜在合格研究。此外,使用随机效应模型确定PSD的合并发病率和危险因素。总体而言,选取了58项涉及37404例急性中风患者的研究进行荟萃分析。

结果

急性中风患者中PSD的合并发病率为42%(95%置信区间[CI]:36 - 48%),其中南美洲最高(47%),亚洲最低(37%)。值得注意的是,发现年龄较大(优势比[OR]:2.13;95% CI:1.53 - 2.97;p < 0.001)、高血压(OR:1.23;95% CI:1.06 - 1.44;p = 0.007)、糖尿病(OR:1.22;95% CI:1.04 - 1.44;p = 0.014)、中风病史(OR:1.26;95% CI:1.04 - 1.53;p = 0.019)和心房颤动(OR:1.58;95% CI:1.02 - 2.44;p = 0.039)与PSD风险增加相关。相反,性别差异、吸烟、酗酒、肥胖、高脂血症、缺血性心脏病、中风类型和受影响的半球与PSD风险无关。

结论

该摘要报告了急性中风患者中PSD的患病率,并确定了PSD的潜在危险因素,包括年龄较大、高血压、糖尿病、中风病史和心房颤动。

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