Comorbidities associated with dysphagia after acute ischemic stroke.

Autor:	Karisik A; VASCage - Centre on Clinical Stroke Research, Adamgasse 23, Innsbruck, Austria.; Department of Neurology, Medical University of Innsbruck, Anichstrasse 35, Innsbruck, Austria., Bader V; Department of Neurology, Medical University of Innsbruck, Anichstrasse 35, Innsbruck, Austria., Moelgg K; VASCage - Centre on Clinical Stroke Research, Adamgasse 23, Innsbruck, Austria.; Department of Neurology, Medical University of Innsbruck, Anichstrasse 35, Innsbruck, Austria., Buergi L; VASCage - Centre on Clinical Stroke Research, Adamgasse 23, Innsbruck, Austria.; Department of Neurology, Medical University of Innsbruck, Anichstrasse 35, Innsbruck, Austria., Dejakum B; Department of Neurology, Medical University of Innsbruck, Anichstrasse 35, Innsbruck, Austria., Komarek S; Department of Neurology, Medical University of Innsbruck, Anichstrasse 35, Innsbruck, Austria., Eller MT; Department of Neurology, Medical University of Innsbruck, Anichstrasse 35, Innsbruck, Austria., Toell T; Department of Neurology, Medical University of Innsbruck, Anichstrasse 35, Innsbruck, Austria., Mayer-Suess L; Department of Neurology, Medical University of Innsbruck, Anichstrasse 35, Innsbruck, Austria., Pechlaner R; Department of Neurology, Medical University of Innsbruck, Anichstrasse 35, Innsbruck, Austria., Granna J; VASCage - Centre on Clinical Stroke Research, Adamgasse 23, Innsbruck, Austria., Sollereder S; VASCage - Centre on Clinical Stroke Research, Adamgasse 23, Innsbruck, Austria., Rossi S; ICONE - Innsbruck Cognitive Neuroscience, Department for Hearing, Speech and Voice Disorders, Medical University of Innsbruck, Anichstrasse 35, Innsbruck, Austria., Schoenherr G; Department of Neurology, Medical University of Innsbruck, Anichstrasse 35, Innsbruck, Austria., Willeit J; Department of Neurology, Medical University of Innsbruck, Anichstrasse 35, Innsbruck, Austria., Willeit P; Institute of Clinical Epidemiology, Public Health, Health Economics, Medical Statistics and Informatics, Medical University of Innsbruck, Anichstrasse 35, Innsbruck, Austria.; Department of Public Health and Primary Care, University of Cambridge, The Old Schools, Trinity Ln, Cambridge, UK., Lang W; VASCage - Centre on Clinical Stroke Research, Adamgasse 23, Innsbruck, Austria.; Medical Faculty, Sigmund Freud Private University, Freudplatz 1, Vienna, Austria., Kiechl S; VASCage - Centre on Clinical Stroke Research, Adamgasse 23, Innsbruck, Austria.; Department of Neurology, Medical University of Innsbruck, Anichstrasse 35, Innsbruck, Austria., Knoflach M; VASCage - Centre on Clinical Stroke Research, Adamgasse 23, Innsbruck, Austria. michael.knoflach@i-med.ac.at.; Department of Neurology, Medical University of Innsbruck, Anichstrasse 35, Innsbruck, Austria. michael.knoflach@i-med.ac.at., Boehme C; Department of Neurology, Medical University of Innsbruck, Anichstrasse 35, Innsbruck, Austria. christian.boehme@i-med.ac.at.
Jazyk:	angličtina
Zdroj:	BMC neurology [BMC Neurol] 2024 Sep 28; Vol. 24 (1), pp. 358. Date of Electronic Publication: 2024 Sep 28.
DOI:	10.1186/s12883-024-03863-1
Abstrakt:	Background: Pre-existing comorbidities increase the likelihood of post-stroke dysphagia. This study investigates comorbidity prevalence in patients with dysphagia after ischemic stroke. Methods: The data of patients with acute ischemic stroke from two large representative cohorts (STROKE-CARD trial 2014-2019 and STROKE-CARD registry 2020-2022 - both study center Innsbruck, Austria) were analyzed for the presence of dysphagia at hospital admission (clinical swallowing examination). Comorbidities were assessed using the Charlson Comorbidity Index (CCI). Results: Of 2054 patients with ischemic stroke, 17.2% showed dysphagia at hospital admission. Patients with dysphagia were older (77.8 ± 11.9 vs. 73.6 ± 14.3 years, p < 0.001), had more severe strokes (NIHSS 7(4-12) vs. 2(1-4), p < 0.001) and had higher CCI scores (4.7 ± 2.1 vs. 3.8 ± 2.0, p < 0.001) than those without swallowing impairment. Dysphagia correlated with hypertension (p = 0.034), atrial fibrillation (p < 0.001), diabetes (p = 0.002), non-smoking status (p = 0.014), myocardial infarction (p = 0.002), heart failure (p = 0.002), peripheral arterial disease (p < 0.001), severe chronic liver disease (p = 0.002) and kidney disease (p = 0.010). After adjusting for relevant factors, the associations with dysphagia remained significant for diabetes (p = 0.005), peripheral arterial disease (p = 0.007), kidney disease (p = 0.014), liver disease (p = 0.003) and overall CCI (p < 0.001). Conclusions: Patients with multiple comorbidities have a higher risk of developing post-stroke dysphagia. Therefore, early and thorough screening for swallowing impairment after acute ischemic stroke is crucial especially in those with multiple concomitant diseases. Trial Registration: Stroke Card Registry (NCT04582825), Stroke Card Trial (NCT02156778). (© 2024. The Author(s).)
Databáze:	MEDLINE
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