Ischemic Lesion Location Based on the ASPECT Score for Risk Assessment of Neurogenic Dysphagia

Lapa, Sriramya; Foerch, Christian; Singer, Oliver C.; Hattingen, Elke; Luger, Sebastian

doi:10.1007/s00455-020-10204-0

Cited by 13 publications

(14 citation statements)

References 47 publications

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“…Stroke is a common and frequently-occurring disease of the nervous system, and it is an important cause of death or disability of residents worldwide, and the recurrence rate is high [ 22 , 23 ]. According to statistics [ 24 , 25 ], there are about 2 million new stroke patients in China every year, of which 22%-65% of stroke patients are accompanied by dysphagia, the incidence of dysphagia within 3 days of stroke patients is 12%-67%.…”

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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“…The median sample size was 95 (ranging from 20 to 342). Thirteen of the included studies were supratentorial strokes [ 11 , 12 , 13 , 17 , 25 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 ], one infratentorial stroke [ 36 ], and seven both the supratentorial and infratentorial strokes [ 16 , 37 , 38 , 39 , 40 , 41 , 42 ]. Besides, subjects of sixteen studies were in acute phase of stroke [ 11 , 12 , 13 , 14 , 16 , 17 , 25 , 29 , 34 , 35 , 38 , 39 , 41 , 42 , 43 , 44 ], one was in subacute phase of stroke [ 30 ], and one was in chronic phase of stroke [ 28 ], while the stroke phases of the remaining six studies were unclear ( Table 1 ).…”

Section: Resultsmentioning

confidence: 99%

“…As shown in Table 2 , five of the included articles were prospective studies [ 25 , 34 , 38 , 41 , 42 ], five articles were retrospective ones [ 13 , 24 , 30 , 39 , 40 ], while the types of other fourteen articles were unclear. A total of fourteen articles reported being assessor-blinded [ 11 , 12 , 13 , 17 , 28 , 29 , 30 , 34 , 38 , 40 , 41 , 42 , 43 , 44 ], and the other ten were unclear. Twenty-three articles reported consistent assessment for all patients, and the remaining one was unclear [ 25 ].…”

Section: Resultsmentioning

confidence: 99%

Effects of Insular Cortex on Post-Stroke Dysphagia: A Systematic Review and Meta Analysis

Qiao

Cheng

et al. 2022

Brain Sciences

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Objective: To investigate the relationship of lobar and deep brain regions with post-stroke dysphagia (PSD). Method: The databases of Medline, Embase, Web of Science, and Cochrane Library were searched from the establishment to May 2022. Studies that investigated the effects of lesions in lobar and deep brain regions on swallowing function after stroke were screened. The primary outcomes were PSD-related brain regions (including aspiration-related and oral transit time-related brain regions). The secondary outcomes were the incidence rate of PSD. The brain regions with the most overlap in the included studies were considered to be most relevant to PSD, and were presented as percentages. Data were compared utilizing the t-tests for continuous variables and χ2 for frequency-based variables. Result: A total of 24 studies and 2306 patients were included. The PSD-related lobar and deep brain regions included the insular cortex, frontal lobe, temporal gyrus, basal ganglia, postcentral, precentral, precuneus, corona radiate, etc. Among these brain regions, the insular cortex was most frequently reported (taking up 54.2%) in the included studies. Furthermore, the total incidence rate of PSD was around 40.4%, and the incidence of male was nearly 2.57 times as much as that of female (χ2 = 196.17, p < 0.001). Conclusions: In lobar and deep brain regions, the insular cortex may be most relevant to PSD and aspiration, which may be a potentially promising target in the treatment of PSD.

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“…The records of 1378 inpatients (in a 660-bed public tertiary hospital) who were referred to a rehabilitation department for evaluation of swallowing ability between June 2014 and May 2019 were retrospectively reviewed. The study inclusion criteria were age ≧65 years, fever after resuming oral intake, and development of an infectious illness requiring antimicrobial therapy [ 11 , 12 ]. The exclusion criteria were as follows: discontinuation of oral intake (because of terminal cancer, neurodegenerative disease, surgery, recurrence of a cerebrovascular disorder, disturbance of consciousness by psychotropic medication), infection other than pneumonia or UTI, and multiple sources of infection.…”

Section: Methodsmentioning

confidence: 99%

Temporal characteristics of aspiration pneumonia in elderly inpatients: From resumption of oral intake to onset

et al. 2022

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Background Elderly inpatients who develop fevers after resumption of oral intake are often considered to have aspiration pneumonia (AP) and be tentatively fasted. Fasting has been associated with prolonged hospital stays and decreased swallowing ability. The purpose of this study was to compare AP and other infections after resumption of oral intake in elderly inpatients and to identify the clinical characteristics. Patients and methods The records of patients who were admitted to a public tertiary hospital and referred for evaluation of swallowing disability were retrospectively reviewed to identify those who had developed AP, non-AP, or urinary tract infection (UTI) after resumption of oral intake. Eligible patients were enrolled consecutively in the study. The patient characteristics, physical findings, laboratory data, oral intake status at the time of onset of symptoms, and rate of discontinuation of oral intake after onset of infection were compared between the three types of infection. Results A total of 193 patients developed an infectious illness after resuming oral intake. Among them, 114 patients had a diagnosis of AP (n = 45), non-AP (n = 24), or UTI (n = 45). There were no significant differences in patient characteristics, physical findings or laboratory data between the group with AP and the other two groups. AP developed at a median of 6 (range 1–16) days after resumption of oral intake. The rate of discontinuation of oral intake was 91.1% in the AP group, 58.3% in the non-AP group, and 26.7% in the UTI group, respectively. Conclusion Infectious diseases other than AP should be considered in the differential diagnosis when nosocomial fever develops in elderly inpatients more than 17 days after resuming oral intake. Furthermore, nosocomial fever after resuming oral intake has many causes other than AP, and discontinuation of oral intake should be carefully considered.

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Ischemic Lesion Location Based on the ASPECT Score for Risk Assessment of Neurogenic Dysphagia

Cited by 13 publications

References 47 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

Effects of Insular Cortex on Post-Stroke Dysphagia: A Systematic Review and Meta Analysis

Temporal characteristics of aspiration pneumonia in elderly inpatients: From resumption of oral intake to onset

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