Department of Health Sciences and Research, College of Health Professions, Medical University of South Carolina, Charleston.
Department of Healthcare Leadership & Management, College of Health Professions, Medical University of South Carolina, Charleston.
Am J Speech Lang Pathol. 2024 Sep 18;33(5):2487-2499. doi: 10.1044/2024_AJSLP-23-00264. Epub 2024 Aug 1.
A diagnosis of dysphagia and/or depression after stroke can impact the physical, psychological, and social welfare of stroke survivors. Although poststroke depression (PSD) and poststroke dysphagia are known to occur concurrently, there is a paucity of research that has specifically investigated their association. Therefore, we aimed to study the relationship between PSD and poststroke dysphagia during acute inpatient hospitalization and within 90 days after discharge. Furthermore, we aimed to evaluate the odds and hazard of being diagnosed with depression after stroke and estimate the time to depression diagnosis from the initial stroke diagnosis in patients with and without a diagnosis of dysphagia.
Using the acute inpatient hospital data set from our previous work, we pulled additional postdischarge administrative claims data from the 2017 Medicare 5% Limited Data Set and conducted a retrospective, cross-sectional study of patients diagnosed with poststroke dysphagia and PSD.
Patients diagnosed with poststroke dysphagia had 2.7 higher odds of being diagnosed with PSD and had an approximately 1.75-fold higher hazard for PSD diagnosis in the 90 days after discharge compared to patients not diagnosed with dysphagia. Risk factors for PSD included having dysphagia, being female, and having dual eligibility.
Our results demonstrated a significant association between PSD and poststroke dysphagia. Additional research should further explore the impact of PSD on poststroke dysphagia.
中风后吞咽困难和/或抑郁的诊断会影响中风幸存者的身体、心理和社会福利。虽然已知中风后抑郁（PSD）和中风后吞咽困难同时发生，但很少有研究专门探讨它们之间的关联。因此，我们旨在研究急性住院期间和出院后 90 天内 PSD 和中风后吞咽困难之间的关系。此外，我们旨在评估中风后诊断为抑郁的几率和风险，并估计有和没有吞咽困难诊断的患者从初始中风诊断到诊断为抑郁的时间。
利用我们之前工作中的急性住院数据集中的数据，我们从 2017 年 Medicare 5%有限数据集提取了额外的出院后行政索赔数据，并对诊断为中风后吞咽困难和 PSD 的患者进行了回顾性、横断面研究。
与未诊断为吞咽困难的患者相比，诊断为中风后吞咽困难的患者被诊断为 PSD 的几率高 2.7 倍，出院后 90 天内被诊断为 PSD 的风险高 1.75 倍。PSD 的风险因素包括吞咽困难、女性和双重资格。
我们的结果表明 PSD 和中风后吞咽困难之间存在显著关联。进一步的研究应进一步探讨 PSD 对中风后吞咽困难的影响。
