Prevalence of Dysphagia in China: An Epidemiological Survey of 5943 Participants

Zhang, Mengqing; Li, Chao; Zhang, Fang; Han, Xiaoxiao; Qi, Yang; Lin, Tuo; Zhou, Huichang; Tang, Min; Jun-gui, Zhou; Shi, Hongling; Yao, Hui; Xiong, Mingfeng; Pang, Lei; Bao-lan, Wang; Feng, Zhen; Li, Zhanfei; Cao, Changbing; Lü, Xiao; Ding, Yuanyuan; Shen, Shukun; Xu, Zhengyue; Yu, Fan; Chen, Chen; Meng, Ling; Liao, Guiqing; Zhang, Jinxin; Sasegbon, Ayodele; Dou, Zulin

doi:10.1007/s00455-020-10138-7

Cited by 36 publications

(29 citation statements)

References 47 publications

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“…The prevalence of post-stroke dysphagia reported from different studies also varies, and the prevalence varies by region. Furthermore, an estimated 41% of stroke patients in the United States experience difficulty swallowing (Crary et al, 2013 ), and nearly 51.14% of stroke inpatients have deglutition disorder in China (Zhang et al, 2021 ). Post-stroke dysphagia is an impaired swallowing function caused by an imbalance in the coordination of swallowing muscles and neural regulation, which prevents the patients from eating normally (Sandoval-Munoz and Haidar, 2021 ).…”

Section: Introductionmentioning

confidence: 99%

The Effectiveness of Repetitive Transcranial Magnetic Stimulation for Post-stroke Dysphagia: A Systematic Review and Meta-Analysis

Wen

Liu

Zhong

et al. 2022

Front. Hum. Neurosci.

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BackgroundRepetitive transcranial magnetic stimulation (rTMS) applied to the mylohyoid cortical region has positive clinical effects on post-stroke. Therefore, we conducted a meta-analysis to investigate the efficacy of rTMS for patients with post-stroke dysphagia.MethodsAccording to PRISMA guidelines, we searched the databases of MEDLINE (PubMed), Cochrane Library, Embase, Web of Science, CNKI, Wangfang. We searched for studies of randomized controlled trials (RCTs) of rTMS to treat dysphagia after stroke and screened by inclusion and exclusion criteria. Features of RCTs were extracted. The heterogeneity of the trials was measured by I2 statistic.ResultsIn total, 11 RCTs with 463 dysphagia patients fulfilled our inclusion criteria. In our analysis, rTMS demonstrated a great beneficial effect for post-stroke dysphagia when combined with traditional swallowing exercises. Moreover, a greatly significant difference (P = 0.008) was noted based on stimulation frequency (high frequency vs. low frequency). Additionally, no significant difference (P = 0.53) was observed based on stimulation site (affected vs. unaffected hemisphere).ConclusionsOverall, rTMS can effectively accelerate the improvement of swallowing function in patients with post-stroke swallowing disorders.

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Section: Introductionmentioning

confidence: 99%

The Effectiveness of Repetitive Transcranial Magnetic Stimulation for Post-stroke Dysphagia: A Systematic Review and Meta-Analysis

Wen

Liu

Zhong

et al. 2022

Front. Hum. Neurosci.

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“…The mortality of cerebrovascular diseases in China was 149.49 per 100,000 in 2018. 1 Dysphagia is common among stroke survivors, affecting 27–64% of patients, 2 , 3 while affecting 25–81% of survivors 70 years or older. 4 Dysphagia can increase the risk of malnutrition, mortality, and hospitalization complications.…”

Section: Introductionmentioning

confidence: 99%

“… 4 Dysphagia can increase the risk of malnutrition, mortality, and hospitalization complications. 2 , 3 , 5 , 6 Dysphagia is a significant risk factor for malnutrition in stroke patients older than 70 years. 3 , 6 , 7 The nutrition screening 2002 (NRS2002) is recommended for hospital patients by the European Society of Parenteral and Enteral Nutrition (ESPEN) 8 and is suitable in screening malnutrition risk among Chinese geriatric inpatients older than 70 years.…”

Section: Introductionmentioning

confidence: 99%

“… 2 , 3 , 5 , 6 Dysphagia is a significant risk factor for malnutrition in stroke patients older than 70 years. 3 , 6 , 7 The nutrition screening 2002 (NRS2002) is recommended for hospital patients by the European Society of Parenteral and Enteral Nutrition (ESPEN) 8 and is suitable in screening malnutrition risk among Chinese geriatric inpatients older than 70 years. 9 According to NRS2002, stroke patients older than 70 years are defined as being at malnutrition risk.…”

Section: Introductionmentioning

confidence: 99%

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Dysphagia Management and Outcomes in Elderly Stroke Patients with Malnutrition Risk: Results from Chinese Stroke Center Alliance

Zhang¹,

Li²,

Gu³

et al. 2022

CIA

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Purpose To investigate the effectiveness of dysphagia screening and subsequent swallowing rehabilitation in elderly stroke patients with malnutrition risk. Patients and Methods Based on the Chinese Stroke Center Alliance (CSCA) from August 1, 2015 to July 21, 2019, we compared the in-hospital adverse outcomes among stroke patients (including ischemic stroke, intracranial hemorrhage, and subarachnoid hemorrhage) over 70 years old with and without dysphagia screening. The primary outcome was in-hospital all-cause mortality. Secondary outcomes were the composite endpoint of discharge against medical advice (DAMA) or in-hospital death. Results Among 365,530 stroke patients ≥ 70 years old with malnutrition risk in the CSCA, documented dysphagia screening was performed for 288,764 (79.0%) participants. Of these, 41,482 (14.37%) patients had dysphagia, and 33,548 (80.87%) patients received swallowing rehabilitation. A total of 1,694 (0.46%) patients experienced in-hospital death. After adjustment for traditional risk factors, dysphagia screening was associated with a low risk of all-cause mortality in stroke patients [adjusted odds ratio (aOR): 0.75, 95% confidence interval (CI):0.65–0.87]. Compared to patients with dysphagia who did not receive swallowing rehabilitation, patients reveiving swallowing rehabilitation had a reduced risk of in-hospital death (aOR:0.39, 95% CI: 0.33–0.46). Additionally, dysphagia screening had a lower risk for the composite endpoint of DAMA or in-hospital death (aOR:0.83,95% CI: 0.80–0.87), as did subsequent swallowing rehabilitation (aOR:0.43,95% CI: 0.40–0.47). Similar results were observed in the sensitivity analysis through inverse probability of treatment weighting, propensity score matching, and excluding patients without National Institutes of Health Stroke Scale scores. A similar association was observed between dysphagia management and adverse clinical outcomes in ischemic stroke and intracranial hemorrhage patients. Conclusion Dysphagia screening and swallowing rehabilitation were associated with a reduced risk of in-hospital death and composite outcome of DAMA or in-hospital death for stroke patients with malnutrition risk. Future research should concentrate on improving the quality of medical care for dysphagia management to improve patients’ outcomes.

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“…Dysphagia is a common and serious problem in patients with neurologic diseases and has a prevalence of 37-78%. [1][2][3] Decreased laryngeal elevation caused by weakness in pharyngeal muscles is a main cause of dysphagia, which can result in aspiration and pharyngeal residue during swallowing. 4 Till now, diverse treatments including modifying food and fluid, altering posture and changing swallowing strategies with some rehabilitative techniques, and 2-channel neuromuscular electrical stimulation (NMES) have been used for the treatment of dysphagia.…”

Section: Introductionmentioning

confidence: 99%

Compensatory Effects of Sequential 4-Channel Neuromuscular Electrical Stimulation for the Treatment of Acute, Subacute, and Chronic Dysphagia in a Prospective, Double-Blinded Randomized Clinical Trial

Lee

Park

Jang

et al. 2021

Neurorehabil Neural Repair

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Background. The precise mechanism of 2-channel neuromuscular electrical stimulation (NMES) treatment is unknown, and controversy remains over its efficacy. The sequential 4-channel NMES was newly developed based on normal contractile sequences of swallowing-related muscles. Objective. To assess the clinical efficacy of sequential 4-channel NMES during swallowing. Methods. In this prospective RCT, 52 inpatients with dysphagia (acute, subacute, and chronic state) after stroke, brain tumor, or encephalitis were enrolled. Participants who underwent a videofluoroscopic swallowing study (VFSS) and clinical evaluation were enrolled and were randomly assigned to the 4-channel NMES or sham group. The 4-channel NMES and sham groups swallowed thin and honey-like fluids under NMES (sequential stimulation on suprahyoid and infrahyoid) and sham stimulation, respectively. The procedures were evaluated with the VFSS. Pre- and post-treatment evaluations were performed with the videofluoroscopic dysphagia scale (VDS), penetration–aspiration scale (PAS), Likert scale, and kinematic analysis. Results. The 4-channel NMES group showed significantly greater improvements than the sham group with respect to oral VDS, pharyngeal VDS, total VDS, and PAS ( P < .05). Furthermore, the Likert scale for satisfaction, easiness, and discomfort for swallowing showed favorable results for the 4-channel NMES group ( P < .05). In the kinematic analysis, the peak speed point, distance, and velocity of hyoid movement were significantly greater in the 4-channel NMES group ( P < .05). Conclusions. Sequential 4-channel NMES activating the suprahyoid, thyrohyoid, and other infrahyoid muscles during swallowing showed significant clinical improvement with respect to VDS, PAS, and kinematic analysis. Therefore, sequential 4-channel NMES is a potential new functional electrical stimulation system for the treatment of dysphagia.

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Prevalence of Dysphagia in China: An Epidemiological Survey of 5943 Participants

Cited by 36 publications

References 47 publications

The Effectiveness of Repetitive Transcranial Magnetic Stimulation for Post-stroke Dysphagia: A Systematic Review and Meta-Analysis

The Effectiveness of Repetitive Transcranial Magnetic Stimulation for Post-stroke Dysphagia: A Systematic Review and Meta-Analysis

Dysphagia Management and Outcomes in Elderly Stroke Patients with Malnutrition Risk: Results from Chinese Stroke Center Alliance

Compensatory Effects of Sequential 4-Channel Neuromuscular Electrical Stimulation for the Treatment of Acute, Subacute, and Chronic Dysphagia in a Prospective, Double-Blinded Randomized Clinical Trial

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