Analysis Of Factors Influencing The Therapeutic Effect Of Post-stroke Dysphagia Patients

Objective:To investigate the prognostic factors of stroke patients with dysphagia and discover risk factors and protective factors,providing insights for treatment of PSD patients to improve the nutritional status and prognosis of patients.Method:One hundred and eighty post-stroke dysphagia(PSD)patients were enrolled in this retrospective study at the rehabilitation medicine department of our hospital from February 2017 to December 2018.All patients were diagnosed with cerebral hemorrhage or cerebral infarction.Demographic and clinical data were obtained from medical record.The primary outcome measurement is Water Swallow Test(WST)and the second outcome measurement is length of stay at the rehabilitation department.Participants were grouped into the recovered and unrecovered by WST level at discharge.The demographic and clinical characteristics of were compared,and then a logistic regression model was estimated to find prognostic risk factors,and multiple linear regression models were utilized to predict the length of hospital stay.In addition,random forest models were employed to estimate the importance of these factors which are differ significantly.Results:1.There were significant differences between the two groups in the mouth-opening degree,DSS(drooling severity scale)degree,MMSE(Mini-mental State Examination)degree,Barthel index scores,and BBS(Berg balance scale)scores.2.Logistic regression model results suggested stroke type(OR = 0.17,p= 0.050),MMSE degree(OR = 0.10,p= 0.017),DSS degree(OR = 5.51,p = 0.005),serum hemoglobin(HB)level(OR = 0.95,p = 0.020)has significant predictive value for the outcome of PSD.In addition,patients with Obstructive sleep apnea hypopnea syndrome(OSAHS)had a worse outcome(OR = 4.39,p= 0.105).3.Gender,BMI,drinking,hypertension,recurrent stroke,WST degree on admission,BBS scores,DSS degree,and days between onset to admission have significant predictive value for the length of stay hospital of PSD patients.Furthermore,high BMI,recurrent stroke,and higher WST degree on admission were associate with a longer length of stay and.female,previous drinking,hypertension,and high BBS scores at admission were related to a shorter length of stay hospital,Conclusion:1.Mouth-opening degree,DSS degree,MMSE degree,Barthel scores,and BBS scores differ significantly between recovered unrecovered group.2.The swallowing function of PSD patients at discharge was related to the type of stroke and MMSE grade,DSS grade and serum HB content at admission.3.The length of stay at hospital of PSD patients is related to gender,BMI,alcohol consumption,hypertension,recurrent stroke,WST degree on admission,BBS score,DSS degree,and days between onset to admission.