TY - JOUR
T1 - Health Factors Associated With Development and Severity of Poststroke Dysphagia
T2 - An Epidemiological Investigation
AU - Krekeler, Brittany N
AU - Schieve, Heidi J P
AU - Khoury, Jane
AU - Ding, Lili
AU - Haverbusch, Mary
AU - Alwell, Kathleen
AU - Adeoye, Opeolu
AU - Ferioloi, Simona
AU - Mackey, Jason
AU - Woo, Daniel
AU - Flaherty, Matthew
AU - La Rosa, Felipe De Los Rios
AU - Demel, Stacie
AU - Star, Michael
AU - Coleman, Elisheva
AU - Walsh, Kyle
AU - Slavin, Sabreena
AU - Jasne, Adam
AU - Mistry, Eva
AU - Kleindorfer, Dawn
AU - Kissela, Brett
PY - 2024/4/2
Y1 - 2024/4/2
N2 - BACKGROUND: Dysphagia after stroke is common and can impact morbidity and death. The purpose of this population-based study was to determine specific epidemiological and health risk factors that impact development of dysphagia after acute stroke.METHODS AND RESULTS: Ischemic and hemorrhagic stroke cases from 2010 and 2015 were identified via chart review from the GCNKSS (Greater Cincinnati Northern Kentucky Stroke Study), a representative sample of ≈1.3 million adults from southwestern Ohio and northern Kentucky. Dysphagia status was determined on the basis of clinical assessments and necessity for alternative access to nutrition via nasogastric or percutaneous endoscopic gastrostomy tube placement. Comparisons between patients with and without dysphagia were made to determine differences in baseline characteristics and premorbid conditions. Multivariable logistic regression determined factors associated with increased risk of dysphagia. Dysphagia status was ascertained from 4139 cases (1709 with dysphagia). Logistic regression showed that increased age, Black race, higher National Institutes of Health Stroke Scale score at admission, having a hemorrhagic stroke (versus infarct), and right hemispheric stroke increased the risk of developing dysphagia after stroke. Factors associated with reduced risk included history of high cholesterol, lower prestroke modified Rankin Scale score, and white matter disease.CONCLUSIONS: This study replicated previous findings of variables associated with dysphagia (older age, worse stroke, right-sided hemorrhagic lesions), whereas other variables identified were without clear biological rationale (eg, Black race, history of high cholesterol, and presence of white matter disease) and should be investigated in future studies to determine biological relevance and potential influence in stroke recovery.
AB - BACKGROUND: Dysphagia after stroke is common and can impact morbidity and death. The purpose of this population-based study was to determine specific epidemiological and health risk factors that impact development of dysphagia after acute stroke.METHODS AND RESULTS: Ischemic and hemorrhagic stroke cases from 2010 and 2015 were identified via chart review from the GCNKSS (Greater Cincinnati Northern Kentucky Stroke Study), a representative sample of ≈1.3 million adults from southwestern Ohio and northern Kentucky. Dysphagia status was determined on the basis of clinical assessments and necessity for alternative access to nutrition via nasogastric or percutaneous endoscopic gastrostomy tube placement. Comparisons between patients with and without dysphagia were made to determine differences in baseline characteristics and premorbid conditions. Multivariable logistic regression determined factors associated with increased risk of dysphagia. Dysphagia status was ascertained from 4139 cases (1709 with dysphagia). Logistic regression showed that increased age, Black race, higher National Institutes of Health Stroke Scale score at admission, having a hemorrhagic stroke (versus infarct), and right hemispheric stroke increased the risk of developing dysphagia after stroke. Factors associated with reduced risk included history of high cholesterol, lower prestroke modified Rankin Scale score, and white matter disease.CONCLUSIONS: This study replicated previous findings of variables associated with dysphagia (older age, worse stroke, right-sided hemorrhagic lesions), whereas other variables identified were without clear biological rationale (eg, Black race, history of high cholesterol, and presence of white matter disease) and should be investigated in future studies to determine biological relevance and potential influence in stroke recovery.
KW - Adult
KW - Humans
KW - Deglutition Disorders/diagnosis
KW - Hemorrhagic Stroke
KW - Stroke/complications
KW - Leukoencephalopathies
KW - Cholesterol
U2 - 10.1161/JAHA.123.033922
DO - 10.1161/JAHA.123.033922
M3 - Article
C2 - 38533959
SN - 2047-9980
VL - 13
SP - e033922
JO - Journal of the American Heart Association
JF - Journal of the American Heart Association
IS - 7
ER -