AUTHOR=Song Wenjing , Wu Minmin , Wang Haoran , Pang Ruifeng , Zhu Luwen 

TITLE=Prevalence, risk factors, and outcomes of dysphagia after stroke: a systematic review and meta-analysis

JOURNAL=Frontiers in Neurology

VOLUME=Volume 15 - 2024

YEAR=2024

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2024.1403610

DOI=10.3389/fneur.2024.1403610

ISSN=1664-2295

ABSTRACT=Dysphagia is a common complication after stroke, which not only brings adverse outcomes, but also greatly affects the quality of life of patients. At present, there is no systematic review or meta-analysis to comprehensively evaluate the epidemiological characteristics of dysphagia after stroke (psd).A systematic review of the prevalence, risk factors, and prognosis of dysphagia after stroke is essentialThrough December 31, 2022, a comprehensive literature search was performed for observational studies related to psd. 5 databases were retrieved.Random-effects models were used to estimate the pooled prevalence, odds ratio (OR)and 95% CIs.A total of 34 studies were included, and the results showed that overall prevalence of psd was 46.6% (95% CI, 0.405-0.528), The prevalence of dysphagia in ischemic stroke and hemorrhagic stroke were 43.6% (95% CI 0.370-0.501) and 58.8% (95% CI 0.519-0.654); The prevalence of psd in Africa was 49.4%(95% CI, 0.196-0.792, in Asia was 40.1% (95% CI, 0.348-0.454), in Europe was 45.8%(95% CI, 0.327-0.590), in North America was 44.3%(95% CI, 0.370-0.517), in South America was 57.5%(95% CI, 0.441-0.708), in Oceania was 64.1%(95%CI, 0.558, 0.724). In risk factor analysis, hypertension, previous stroke and atrial fibrillation were significantly associated with promoting the occurrence of PSD, pooled OR respectively OR=1.179, [(95% CI ,1.002-1.386), p ＜ 0.05] ， pooled OR=1.514[(95% CI ,1.204-1.905),p＜0.001]，and pooled OR=1.980, [(95% CI ,1.580-2.481) , p＜0.001]; In outcome studies, the prevalence of aphasia in psd was 35.6%(95%CI,0.213-0.499), the prevalence of dysarthria in psd was 54.5%(95%CI,0.293-0.798); The prevalence of respiratory tract infection was 27.1% (95%CI, -0.038-0.579), the prevalence of pneumonitis was 32.1% (95%CI,0.224-0.418), Persistence of dysphagia at discharge and at one month, respectively 74.5%(95%CI, 0.621-0.869)and 50.9%(95%CI, 0.142-0.876), Mortality rates for psd patients during admission and discharge, at one month, three months, and one year were 11.8%(95%CI, 0.083-0.152), 26.5%(95%CI, 0.170-0.359), 25.7%(95%CI, 0.19-0.324)and 31.3%(95%CI, 0.256-0.369).This study found that the overall prevalence of psd was 46.6%.Prevalence is most influenced by diagnose method. Hypertension, history of stroke, atrial fibrillation, patient age, and stroke severity were risk factors significantly associated with psd. And the prevalence of aphasia, dysarthria, respiratory tract infection and pneumonitis in psd patients is 2-4 times that of patients without psd.