Sadeghi Zahra, Afshar Mohamadreza, Memarian Asefeh, Flowers Heather L
Department of Speech Therapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
Department of Speech Therapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran.
Syst Rev. 2024 May 2;13(1):121. doi: 10.1186/s13643-024-02530-3.
Oropharyngeal dysphagia (OPD) can be functionally debilitating in persons with multiple sclerosis (pwMS). OPD induces alterations in safety and efficiency of food and/or liquid ingestion and may incur negative sequalae such as aspiration pneumonia or malnutrition/dehydration. Early detection and timely management of OPD in pwMS could prevent such complications and reduce mortality rates. Identifying risk factors of OPD relative to its onset or repeat manifestation will enable the development of care pathways that target early assessment and sustained management. The aims of this systematic review are to compile, evaluate, and summarize the existing literature reporting potential risk factors and associated long-term outcomes (e.g., aspiration pneumonia, malnutrition, dehydration, and/or death) of OPD in pwMS.
We will undertake a systematic review to identify studies that describe patterns and complications of OPD in pwMS. Variables of interest include predictors of OPD along with long-term outcomes. We will search MEDLINE, Embase, CINAHL, AMED, the Cochrane Library, Web of Science, and Scopus. We will consider studies for inclusion if they involve at least 30 adult participants with MS and report risk factors for OPD and/or its long-term outcomes. Studies will be excluded if they refer to esophageal or oropharyngeal dysphagia induced by causes other than multiple sclerosis. Study selection and data extraction will be performed by two independent assessors for abstract and full article review. We will present study characteristics in tables and document research findings for dysphagia-related risk factors or its complications via a narrative format or meta-analysis if warranted (e.g., mean difference and/or risk ratio measurements). All included studies will undergo risk-of-bias assessment conducted independently by two authors with consensus on quality ratings.
There is a lacune for systematic reviews involving risk factors and long-term outcomes of dysphagia in pwMS to date. Our systematic review will provide the means to develop accurate and efficient management protocols for careful monitoring and evaluation of dysphagia in pwMS. The results of this systematic review will be published in a peer-reviewed journal.
PROSPERO CRD42022340625.
口咽吞咽困难（OPD）会使多发性硬化症患者（pwMS）的身体机能衰退。OPD会导致食物和/或液体摄入的安全性和效率发生改变，并可能引发诸如吸入性肺炎或营养不良/脱水等不良后果。早期发现并及时处理pwMS患者的OPD可以预防此类并发症并降低死亡率。识别与OPD发病或复发相关的危险因素将有助于制定针对早期评估和持续管理的护理路径。本系统评价的目的是汇编、评估和总结现有文献，这些文献报告了pwMS患者OPD的潜在危险因素及相关长期后果（如吸入性肺炎、营养不良、脱水和/或死亡）。
我们将进行一项系统评价，以识别描述pwMS患者OPD模式和并发症的研究。感兴趣的变量包括OPD的预测因素以及长期后果。我们将检索MEDLINE、Embase、CINAHL、AMED、Cochrane图书馆、科学网和Scopus。如果研究涉及至少30名成年MS患者，并报告OPD的危险因素和/或其长期后果，我们将考虑纳入这些研究。如果研究涉及由多发性硬化症以外的原因引起的食管或口咽吞咽困难，则将其排除。研究选择和数据提取将由两名独立评估人员进行，以进行摘要和全文审查。我们将以表格形式呈现研究特征，并通过叙述形式或在必要时进行荟萃分析（如均值差异和/或风险比测量）记录吞咽困难相关危险因素或其并发症的研究结果。所有纳入研究将由两名作者独立进行偏倚风险评估，并就质量评级达成共识。
迄今为止，关于pwMS患者吞咽困难危险因素和长期后果的系统评价存在空白。我们的系统评价将为制定准确有效的管理方案提供方法，以便对pwMS患者的吞咽困难进行仔细监测和评估。本系统评价的结果将发表在同行评审期刊上。
PROSPERO CRD42022340625
