Status Of Dysphagia After Ischemic Stroke: A Korean Nationwide Study

Nayeon Ko, Hyun Haeng Lee, Min Kyun Sohn, Deog Young Kim, Yong Il Shin, Gyung Jae Oh, Yang Soo Lee, Min Cheol Joo, So Young Lee, Min Keun Song, Junhee Han, Jeonghoon Ahn, Young Hoon Lee, Won Hyuk Chang, Soo Mi Choi, Seon kui Lee, Jongmin Lee, Yun Hee Kim

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12 Scopus citations

Abstract

Objective: To identify the incidence of dysphagia after ischemic stroke and determine factors affecting the presence of dysphagia. Design: Retrospective case-control study. This was an interim analysis of a prospective multicenter Korean stroke cohort. Setting: Acute care university hospitals. Participants: Patients (N=6000) with first-ever acute ischemic stroke. Patients were divided into 2 groups according to the presence or absence of dysphagia confirmed at 7 days after onset using the American Speech-Language-Hearing Association National Outcomes Measurement System (ASHA-NOMS) scale, which was determined after conducting screening or standardized tests. Interventions: Not applicable. Main Outcome Measures: Age at stroke onset, body mass index (BMI), premorbid modified Rankin Scale (mRS), brainstem lesions, National Institutes of Health Stroke Scale (NIHSS), poststroke mRS, and ASHA-NOMS swallowing level at poststroke day 7 were evaluated. Results: Among patients with ischemic stroke, 32.3% (n=1940) had dysphagia at 7 days after stroke onset. At discharge, 80.5% (n=1561) still had dysphagia. The prediction model for the presence of dysphagia identified age at onset, underweight (BMI <18.5 kg/m2), premorbid mRS, brainstem lesions, and NIHSS as independent predictors. The odds ratio (OR) for the presence of dysphagia significantly increased with underweight (OR, 1.6684; 95% confidence interval [CI], 1.27-2.20), increased age at onset (OR, 1.0318; 95% CI, 1.03-1.04), premorbid mRS (OR, 1.1832; 95% CI, 1.13-1.24), brainstem lesions (OR, 1.6494; 95% CI, 1.39-1.96), and NIHSS (OR, 1.2073; 95% CI, 1.19-1.23). Conclusions: The incidence of dysphagia after ischemic stroke was 32.3%. The prediction model for the presence of dysphagia identified age, low BMI, premorbid disabilities, brainstem lesions, and NIHSS as predictive factors.

Original languageEnglish
Pages (from-to)2343-2352.e3
JournalArchives of Physical Medicine and Rehabilitation
Volume102
Issue number12
DOIs
StatePublished - Dec 2021

Bibliographical note

Funding Information:
Supported by a research program funded by the Korea Centers for Disease Control and Prevention (grant no. 2019E320202) and by a grant of the MD-PhD/Medical Scientist Training Program through the Korea Health Industry Development Institute and funded by the Ministry of Health and Welfare, Republic of Korea.

Publisher Copyright:
© 2021 The American Congress of Rehabilitation Medicine

Keywords

  • Deglutition disorders
  • Rehabilitation
  • Stroke

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