Dysphagia Prevalence and Recovery After Extubation in Neurosurgical ICU Patients: A Cross‐Sectional Study Based on the GuSS ‐ ICU Scale

BACKGROUND: Post-extubation dysphagia (PED) is a common complication in neurosurgical ICU (NICU) patients, increasing the risks of aspiration, pneumonia and malnutrition. Limited research has examined how PED prevalence and recovery vary across different neurological disease types. AIM: This study aimed to investigate the prevalence and recovery rates of post-extubation dysphagia in neurosurgical ICU patients with intracerebral haemorrhage, cerebral ischaemia, or intracranial tumours. It further sought to identify disease-specific differences and contributing factors to inform the development of individualised swallowing rehabilitation strategies. STUDY DESIGN: This cross-sectional study consecutively enrolled eligible patients. Swallowing function was assessed using the Gugging Swallowing Screen for ICU (GuSS-ICU) at 24 h post-extubation and at discharge (score < 15 = dysphagia). Prevalence, improvement rates and associated factors (via multivariate logistic regression) were analysed. RESULTS: A total of 341 participants were included. The overall prevalence of dysphagia was 85.3%. Patients with intracerebral haemorrhage exhibited the highest prevalence (OR = 1.774, p = 0.008) and a relatively lower improvement rate (OR = 1.992, p = 0.006). Compared to haemorrhagic stroke, patients with cerebral ischaemia showed a slightly better recovery trend (OR = 1.408, p = 0.111), although overall improvement remained limited (OR = 0.659, p = 0.040). The poorest recovery was observed in patients with intracranial tumours (OR = 0.374, p = 0.002). CONCLUSIONS: The prevalence and recovery of PED varied significantly depending on the neurological disorder. Patients with ICH were at the highest risk, while those with intracranial tumours faced the poorest prognosis for recovery. RELEVANCE TO CLINICAL PRACTICE: These findings highlight the critical need for early and routine dysphagia screening in this vulnerable population. Understanding these disease-specific patterns allows clinicians to identify high-risk patients earlier and provides an evidence-based foundation for creating personalised swallowing rehabilitation strategies.