Analysis of Factors That Influence the Prognosis of Swallowing Function Rehabilitation Therapy in Patients with Dysphagia After Medullary Infarction

Zhang, Di; Li, Yang; Li, Heping; Fu, Weifeng; Zeng, Jing; Zeng, Xi

doi:10.2147/ndt.s341353

Cited by 4 publications

(4 citation statements)

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“…Swallowing disorders can occur in all stages from the cognitive stage to the esophageal stage [ 35 ]. Patients will experience prolonged oral passage time and pharyngeal swallowing delay, and they are prone to aspiration before and during swallowing [ 36 ]. Treatment and nursing care of patients with dysphagia after stroke is a holistic process from swallowing assessment to rehabilitation, emphasizing multidisciplinary participation and comprehensive training [ 37 – 39 ].…”

Section: Discussionmentioning

confidence: 99%

Risk factors of dysphagia in patients with ischemic stroke: A meta-analysis and systematic review

Yang

Pan

2022

PLoS ONE

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Background Dysphagia is a common yet serious complication in stroke patients. We aimed to conduct a meta-analysis and systematic review to evaluate the risk factors of dysphagia in patients with ischemic stroke, to provide insights to the clinical treatment and nursing care of dysphagia. Methods We searched PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI) and Wanfang Database, China Biomedical Literature Database (CBM) for studies on dysphagia in patients with ischemic stroke up to January 31, 2022. The quality of the literature was evaluated using the Newcastle-Ottawa scale. Meta-analysis was performed using RevMan 5.3 software. Results A total of 10 studies involving 4637 ischemic stroke patients were included, 1183(25.51%) patients had dysphagia after stroke. The synthesized outcomes showed that elder age (SMD = 0.42, 95%CI:0.34–0.50), hypertension (OR = 1.96, 95%CI:1.48–2.61), diabetes (OR = 1.83, 95%CI:1.47–2.28), brainstem stroke (OR = 2.12, 95%CI:1.45–3.09) were associated with dysphagia in patients with ischemic stroke (all P<0.05). There was no significant difference in the gender between dysphagia and no dysphagia patients (OR = 1.07, 95%CI:0.91–1.27, P = 0.40). Egger regression tests indicated there were no significant publication biases in the synthesized outcomes (all P>0.05). Conclusions Elder age, hypertension, diabetes and brainstem stroke are associated with the development of dysphagia in patients with ischemic stroke. Attention should be paid to the assessment and early intervention of those risk factors for dysphagia to improve the prognosis of stroke patients.

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Section: Discussionmentioning

confidence: 99%

Risk factors of dysphagia in patients with ischemic stroke: A meta-analysis and systematic review

Yang

Pan

2022

PLoS ONE

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“…3 Based on the lesion, dysphagia following ischemic stroke can be categorized into bulbar and pseudobulbar palsy, with the former predominantly affecting the medulla oblongata of the brainstem. 4 In addition to dysphagia, the patients with bulbar palsy after ischemic stroke typically present with symptoms such as hoarseness, and dysarthria. 5 Unfortunately, corresponding treatment continues to be a challenge.…”

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confidence: 99%

Effect of Intermittent Oro-Esophageal Tube Feeding in Bulbar Palsy After Ischemic Stroke: A Randomized Controlled Study

Zeng,

Zhao,

et al. 2024

Stroke

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BACKGROUND: Nasogastric tube feeding (NG) has been widely used in patients with bulbar palsy after ischemic stroke but is associated with a significant risk of complications including malnutrition and pneumonia. Intermittent oro-esophageal tube feeding (IOE) can help alleviate these concerns. This study explored the clinical effect of IOE versus NG on nutritional status, swallowing function, stroke-associated pneumonia, and depression in patients with bulbar palsy after ischemic stroke. METHODS: This randomized controlled study included 148 patients with bulbar palsy after ischemic stroke who underwent routine treatment and swallowing rehabilitation training in the Department of Rehabilitation Medicine between July 2017 and July 2019 in China. The participants were randomly divided into the IOE group (n=74) and NG group (n=74) with IOE and NG as nutritional supports, respectively. The primary outcome was nutritional status including (1) body mass index (kg/m 2 ), (2) serum ALB (albumin, g/L), and (3) PA (prealbumin, mg/L). The secondary outcomes were (1) swallowing function including (i) Functional Oral Intake Scale (FOIS) and (ii) Penetration-Aspiration Scale, (2) pneumonia, (3) depression, and (4) adverse events. Statistical analyses for continuous outcomes were performed using t test, Mann-Whitney U test and Wilcoxon signed-rank test and categorical variables using χ 2 test. SPSS 21.0 was used for all analysis. RESULTS: There were no significant baseline differences between the 2 groups. After the treatment, the IOE group demonstrated significantly better results compared with the NG group in ALB ([32.71±0.94] versus [32.28±0.81] g/L; P =0.003), PA ([278.15±13.81] versus [270.31±15.08] mg/L; P =0.001], body mass index ([19.77±1.03] versus [19.41±0.98] kg/m 2 ; P =0.002], FOIS ( P <0.001), Penetration-Aspiration Scale ( P <0.001), stroke-associated pneumonia ([1, 4.05%] versus [26, 35.14%]; P <0.001), depression ([1, 1.35%] versus [44, 59.46%]; P <0.001) and overall less adverse events (reflux, fever, discomfort in the throat; P <0.001). CONCLUSIONS: In patients with dysphagia with bulbar palsy after ischemic stroke who received routine treatment and swallowing rehabilitation training, IOE is safer and more conducive to the improvement of nutritional status, swallowing function, stroke-associated pneumonia, and depression than NG. REGISTRATION: URL: https://www.chictr.org.cn ; Unique identifier: ChiCTR-INC-17011741.

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“…Using the research protocol, 4605 relevant studies were retrieved from the databases, of which 764 were excluded for duplication and 3276 were excluded following title and abstract screening. Finally, 28 publications (Calvo et al., 2019; Hu et al., 2013; Ikenaga et al., 2017; Inooka et al., 2022; Kumar et al., 2014; Lan et al., 2002; Liao et al., 2022; Lin et al., 2019; Myung & Pyun, 2022; Nakadate et al., 2016; Nakajima et al., 2012; Nakajima et al., 2012; Nishioka et al., 2017; Ogawa et al., 2021; Peng & Yuan, 2006; Shimizu et al., 2019; Sreedharan et al., 2022; Takahata et al., 2011; Toscano et al., 2015; Wang et al., 2022; Wang et al., 2011; Wang et al., 2022; Wei et al., 2010; Xi et al., 2021; Xie et al., 2015; Zhan & Jiang, 2018; Zhang et al., 2022; Zhang et al., 2012) were included after reading the full text. Figure 1 shows the flow diagram of studies selection process.…”

Section: Resultsmentioning

confidence: 99%

Demographic and clinical factors associated with recovery of poststroke dysphagia: A meta‐analysis

et al. 2023

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Background Poststroke dysphagia (PSD) recovery depends on various factors. We aimed to provide evidence concerning predictive variables for the recovery of PSD. Methods PubMed, Embase, Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang Database, VIP database of Chinese periodicals, Chinese biomedical literature service system (SinoMed), and Cochrane Library databases were systematically searched up to September 21, 2022. According to the inclusion criteria, the literature searched in the database was screened. The methodological quality of included studies was assessed using the Newcastle‐Ottawa Scale (NOS). Meta‐analysis was performed to identify the factors prognostic for PSD. Results Twenty‐eight studies were eligible, and pooled analyses were allowed for 12 potential prognostic factors. We identified older age, higher National Institutes of Health Stroke Scale (NIHSS) score, lower activities of daily living (ADL) score, lower body mass index (BMI), severe dysphagia on admission, aspiration, brainstem stroke, severe cognitive impairment, and bilateral hemispheric stroke were negative factors for the recovery of PSD, while early intervention and Modified Rankin Scale (mRS) = 0 before onset were protective factors for the recovery of PSD. There was no significant association between stroke type and prognosis of PSD. Conclusion Prognostic factors of PSD summarized in this meta‐analysis could be useful for developing reasonable treatment plan to better promote recovery of swallowing function after stroke.

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Analysis of Factors That Influence the Prognosis of Swallowing Function Rehabilitation Therapy in Patients with Dysphagia After Medullary Infarction

Cited by 4 publications

References 44 publications

Risk factors of dysphagia in patients with ischemic stroke: A meta-analysis and systematic review

Risk factors of dysphagia in patients with ischemic stroke: A meta-analysis and systematic review

Effect of Intermittent Oro-Esophageal Tube Feeding in Bulbar Palsy After Ischemic Stroke: A Randomized Controlled Study

Demographic and clinical factors associated with recovery of poststroke dysphagia: A meta‐analysis

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