Prevalence, severity, and predictors of dysphagia among patients with acute stroke in Oman

Abstract

BACKGROUND: Up to 80% of stroke patients suffer from dysphagia. It is associated with increased morbidity, mortality, and healthcare costs due to aspiration, pneumonia, and malnutrition, which represent a significant burden to stroke survivors, their relatives, and the healthcare system. Early recognition and management of post-stroke dysphagia is key to reducing its complications and enhancing patients’ quality of life. Despite the importance of dysphagia following a stroke and its adverse consequences, no study has investigated dysphagia after stroke in Oman. This study was conducted to estimate the prevalence of post-stroke dysphagia and its severity among acute stroke patients, assess the association between the selected factors and dysphagia, and identify dysphagia predictors. MATERIALS AND METHOD: A cross-sectional descriptive study design was utilized to identify the prevalence and risk factors for post-stroke dysphagia among acute stroke patients (n = 274) admitted to two Omani tertiary hospitals over 6 months. Dysphagia was assessed using the Gugging swallowing screen. Descriptive analysis, correlations, and regression analysis were computed. RESULTS: The prevalence of dysphagia following stroke was 70.1%. Among those who had dysphagia, 37.5% had severe, 31.25% moderate, and 31.25% mild dysphagia. Aging, obesity, having a medical co-morbidity, hypertension, stroke location, low Glasgow Coma Scale (GCS) score, and the use of thrombectomy or thrombolysis therapy were contributing factors and were found to be correlated with post-stroke dysphagia. This study revealed that old age [odds ratio (OR) = 0.961, 95% confidence interval (CI): 0.933–0.989, P = 0.007)], obesity (OR = 0.387, 95% CI: 0.157–0.952, P = 0.039), and low GCS score (OR = 0.027, 95% CI: 0.009–0.077, p=<0.001) were predictors of dysphagia after stroke. CONCLUSION: Post-stroke dysphagia is more common among acute stroke patients. There are various risk factors correlated with dysphagia following a stroke. Therefore, dysphagia predictors should be considered when designing dysphagia prevention strategies to reduce its adverse consequences. Recognition of such predictors may help with the early detection and treatment of dysphagic patients and the implementation of preventive approaches.