Relationship between Post-Stroke Cognitive Impairment and Severe Dysphagia: A Retrospective Cohort Study

Abstract

Objective: To investigate the relationship between post-stroke cognitive impairment (PSCI) and severe post-stroke dysphagia (PSD) and explore the risk factors related to PSCI combined with severe PSD. Methods: Data from patients were collated from the rehabilitation-specific disease database. The Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), Videofluoroscopy Swallowing Study (VFSS), Penetration-aspiration Scale (PAS), and Functional Oral Intake Scale (FOIS) were used to evaluate cognitive and swallowing functions. Differences between groups were determined by the Pearson chi-square test (χ2) or Fisher exact test. PAS and FOIS data were analyzed with the use of the Wilcoxon rank-sum or Kruskal–Wallis test in the prespecified subgroup analysis. Risk factors were investigated by multivariate logistic regression. Results: A total of 1555 patients were identified with PSCI. The results indicated that patients with PSCI had a higher incidence rate of severe PSD as compared to patients without PSCI (p < 0.001). Patients with severe PSCI were more likely to clinically manifest oral phase dysfunction (p = 0.024), while mild PSCI patients mainly manifested pharyngeal phase dysfunction (p < 0.001). There was a significant difference in FOIS score changes between subgroups during the hospitalization period (severe PSCI vs. moderate PSCI and severe PSCI vs. mild PSCI) (all p < 0.001). In addition, multivariate logistic regression revealed pneumonia (p < 0.001), tracheotomy (p < 0.001), and dysarthria (p = 0.006) were related to PSCI, combined with severe PSD. Conclusion: PSCI may be related to severe PSD. Patients with severe PSCI were more likely to manifest oral phase dysfunction, while mild PSCI manifested pharyngeal phase dysfunction. Pneumonia, tracheotomy, and dysarthria were risk factors related to PSCI combined with severe PSD.

Research on a real-time dynamic monitoring method for silent aspiration after stroke based on semisupervised deep learning: A protocol study

“…The oral phase refers to the time when the bolus is being processed in the oral cavity to when the bolus is passing the ramus of the mandible, and the pharyngeal phase refers to the time when the bolus is passing the ramus of the mandible to when upper esophageal sphincter relaxation occurs. 38 Finally, the multisource signals will be segmented according to the labeled time points. The established dataset includes labeled and unlabeled multisource signals.…”

Exploring the Influence of Dysphagia and Tracheostomy on Pneumonia in Patients with Stroke: A Retrospective Cohort Study

“…Swallowing dysfunction in the oral, pharyngeal, and esophageal phases were recorded. The definitions of the different phases are shown in Table 1 [ 26 ]. Different measures were analyzed using Image J open-source software (National Institutes of Health, Bethesda, Maryland) by specifically trained speech-language therapists with more than two years of work experience.…”

Prevalência e fatores associados à disfagia referida entre pessoas idosas no município de São Paulo: Estudo SABE - Saúde, Bem-Estar e Envelhecimento

“…Os resultados indicaram que essa população se mostrou com uma maior taxa de incidência de disfagia grave quando comparadas com pacientes sem esse histórico de déficit cognitivo.A apresentação clinica da disfagia também foi diferente, sendo que pacientes com déficit cognitivo pós-AVC grave apresentaram maior probabilidade de apresentarem a disfagia ocorrendo na fase oral, enquanto os pacientes com déficit cognitivo pós-AVC leve manifestaram disfagia faríngea(Qiao et al, 2022). Os autores concluem o estudo indicando que, pneumonia, traqueostomia e disartria foram fatores de risco associados em seu estudo com déficit cognitivo pós-AVC(Qiao et al, 2022).Dijkshoorn e col. (2021), a partir da observação de que pacientes com câncer de mama enfrentam comprometimento cognitivo parcialmente associáveis ao tratamento, buscaram descrever a variação de frequência do déficit cognitivo durante o tratamento. Para tanto, os autores realizaram uma revisão dos estudos de coorte longitudinais que avaliassem a cognição antes e depois da terapia, relatando a ocorrência de alterações cognitivas a partir de testes neuropsicológicos padronizados e validados.…”