Delayed Dysphagia May Be Sarcopenic Dysphagia in Patients After Stroke

吞咽困难 医学 冲程(发动机) 吞咽 优势比 置信区间 物理疗法 康复 内科学 外科 机械工程 工程类
作者
Akio Shimizu,Ichiro Fujishima,Keisuke Maeda,Kenta Murotani,Tomohisa Ohno,Akiko Nomoto,Shinsuke Nagami,Ayano Nagano,Keisuke Sato,Junko Ueshima,Tatsuro Inoue,Midori Shimizu,Yuria Ishida,Jun Kayashita,M. Suenaga,Naoharu Mori
出处
期刊:Journal of the American Medical Directors Association [Elsevier BV]
卷期号:22 (12): 2527-2533.e1 被引量:12
标识
DOI:10.1016/j.jamda.2021.07.013
摘要

In many cases, swallowing function is impaired after the onset of stroke and gradually improves. However, delayed dysphagia has been reported in some post-stroke patients. Recently, several studies have reported that low muscle strength and decreased muscle mass cause dysphagia. This study aimed to investigate whether these conditions are associated with delayed dysphagia after stroke.A multicenter prospective observational cohort study.Participants included 165 patients with post-stroke dysphagia (mean age 79.1 ± 8.0 years, 53.3% women) admitted to rehabilitation wards for post-stroke rehabilitation.Swallowing function was assessed using the Functional Oral Intake Scale. Delayed dysphagia was defined as dysphagia that occurred more than 7 days after stroke onset. We used logistic regression to examine the independent association between low muscle strength and decreased muscle mass and delayed dysphagia development. Furthermore, we examined the relationship between improvement in dysphagia and delayed dysphagia.Delayed dysphagia was observed in 18 (10.9%) patients. The combination of severely low muscle strength and decreased muscle mass was independently associated with the development of delayed dysphagia (adjusted odds ratio: 4.423, 95% confidence interval: 1.400-13.974, P = .011). Delayed dysphagia had an adverse effect on the improvement of dysphagia during in-hospital rehabilitation (adjusted odds ratio: 0.278, 95% confidence interval: 0.078-0.986, P = .047).The development of delayed dysphagia was influenced by a combination of severely low muscle strength and decreased muscle mass. Furthermore, delayed dysphagia adversely affects the improvement of dysphagia in patients with stroke and needs to be identified early. Identifying delayed dysphagia using the methods proposed in this study and incorporating early intervention may prevent or delay dependency conditions in this population.
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