Prevalence of dysphagia and risk of pneumonia and mortality in acute stroke patients: a meta-analysis
Abstract Background Post-stroke dysphagia (PSD) has been associated with high risk of aspiration pneumonia and mortality. However, limited evidence on pooled prevalence of post-stroke dysphagia and influence of individual, disease and methodological factors reveals knowledge gap. Therefore, to exten...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-05-01
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| Series: | BMC Geriatrics |
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| Online Access: | https://doi.org/10.1186/s12877-022-02960-5 |
| _version_ | 1818206856739291136 |
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| author | Kondwani Joseph Banda Hsin Chu Xiao Linda Kang Doresses Liu Li-Chung Pien Hsiu-Ju Jen Shu-Tai Shen Hsiao Kuei-Ru Chou |
| author_facet | Kondwani Joseph Banda Hsin Chu Xiao Linda Kang Doresses Liu Li-Chung Pien Hsiu-Ju Jen Shu-Tai Shen Hsiao Kuei-Ru Chou |
| author_sort | Kondwani Joseph Banda |
| collection | DOAJ |
| description | Abstract Background Post-stroke dysphagia (PSD) has been associated with high risk of aspiration pneumonia and mortality. However, limited evidence on pooled prevalence of post-stroke dysphagia and influence of individual, disease and methodological factors reveals knowledge gap. Therefore, to extend previous evidence from systematic reviews, we performed the first meta-analysis to examine the pooled prevalence, risk of pneumonia and mortality and influence of prognostic factors for PSD in acute stroke. Methods Our search was conducted in CINAHL, Cochrane Library, EMBASE, Ovid-Medline, PubMed, and Web of Science an initial search in October 2020 and a follow-up search in May 2021. Data synthesis was conducted using the Freeman-Tukey double-arcsine transformation model for the pooled prevalence rate and the DerSimonian-Lard random-effects model for prognostic factors and outcomes of PSD. Results The pooled prevalence of PSD was 42% in 42 studies with 26,366 participants. PSD was associated with higher pooled odds ratio (OR) for risk of pneumonia 4.08 (95% CI, 2.13–7.79) and mortality 4.07 (95% CI, 2.17–7.63). Haemorrhagic stroke 1.52 (95% CI, 1.13–2.07), previous stroke 1.40 (95% CI, 1.18–1.67), severe stroke 1.38 (95% CI, 1.17–1.61), females 1.25 (95% CI, 1.09–1.43), and diabetes mellitus 1.24 (95% CI, 1.02–1.51) were associated with higher risk of PSD. Males 0.82 (95% CI, 0.70–0.95) and ischaemic stroke 0.54 (95% CI, 0.46–0.65) were associated with lower risk of PSD. Haemorrhagic stroke, use of instrumental assessment method, and high quality studies demonstrated to have higher prevalence of PSD in the moderator analysis. Conclusions Assessment of PSD in acute stroke with standardized valid and reliable instruments should take into account stroke type, previous stroke, severe stroke, diabetes mellitus and gender to aid in prevention and management of pneumonia and thereby, reduce the mortality rate. Trial registration https://osf.io/58bjk/?view_only=26c7c8df8b55418d9a414f6d6df68bdb . |
| first_indexed | 2024-12-12T04:19:41Z |
| format | Article |
| id | doaj.art-00e0a7bc5cb8426a9e45c46a8b0903b7 |
| institution | Directory Open Access Journal |
| issn | 1471-2318 |
| language | English |
| last_indexed | 2024-12-12T04:19:41Z |
| publishDate | 2022-05-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Geriatrics |
| spelling | doaj.art-00e0a7bc5cb8426a9e45c46a8b0903b72022-12-22T00:38:21ZengBMCBMC Geriatrics1471-23182022-05-0122111010.1186/s12877-022-02960-5Prevalence of dysphagia and risk of pneumonia and mortality in acute stroke patients: a meta-analysisKondwani Joseph Banda0Hsin Chu1Xiao Linda Kang2Doresses Liu3Li-Chung Pien4Hsiu-Ju Jen5Shu-Tai Shen Hsiao6Kuei-Ru Chou7School of Nursing, College of Nursing, Taipei Medical UniversityInstitute of Aerospace and Undersea Medicine, School of Medicine, National Defense Medical CenterSchool of Nursing, College of Nursing, Taipei Medical UniversitySchool of Nursing, College of Nursing, Taipei Medical UniversityPost-Baccalaureate Program in Nursing, College of Nursing, Taipei Medical UniversitySchool of Nursing, College of Nursing, Taipei Medical UniversitySchool of Nursing, College of Nursing, Taipei Medical UniversitySchool of Nursing, College of Nursing, Taipei Medical UniversityAbstract Background Post-stroke dysphagia (PSD) has been associated with high risk of aspiration pneumonia and mortality. However, limited evidence on pooled prevalence of post-stroke dysphagia and influence of individual, disease and methodological factors reveals knowledge gap. Therefore, to extend previous evidence from systematic reviews, we performed the first meta-analysis to examine the pooled prevalence, risk of pneumonia and mortality and influence of prognostic factors for PSD in acute stroke. Methods Our search was conducted in CINAHL, Cochrane Library, EMBASE, Ovid-Medline, PubMed, and Web of Science an initial search in October 2020 and a follow-up search in May 2021. Data synthesis was conducted using the Freeman-Tukey double-arcsine transformation model for the pooled prevalence rate and the DerSimonian-Lard random-effects model for prognostic factors and outcomes of PSD. Results The pooled prevalence of PSD was 42% in 42 studies with 26,366 participants. PSD was associated with higher pooled odds ratio (OR) for risk of pneumonia 4.08 (95% CI, 2.13–7.79) and mortality 4.07 (95% CI, 2.17–7.63). Haemorrhagic stroke 1.52 (95% CI, 1.13–2.07), previous stroke 1.40 (95% CI, 1.18–1.67), severe stroke 1.38 (95% CI, 1.17–1.61), females 1.25 (95% CI, 1.09–1.43), and diabetes mellitus 1.24 (95% CI, 1.02–1.51) were associated with higher risk of PSD. Males 0.82 (95% CI, 0.70–0.95) and ischaemic stroke 0.54 (95% CI, 0.46–0.65) were associated with lower risk of PSD. Haemorrhagic stroke, use of instrumental assessment method, and high quality studies demonstrated to have higher prevalence of PSD in the moderator analysis. Conclusions Assessment of PSD in acute stroke with standardized valid and reliable instruments should take into account stroke type, previous stroke, severe stroke, diabetes mellitus and gender to aid in prevention and management of pneumonia and thereby, reduce the mortality rate. Trial registration https://osf.io/58bjk/?view_only=26c7c8df8b55418d9a414f6d6df68bdb .https://doi.org/10.1186/s12877-022-02960-5Acute StrokeDysphagiaMortalityPneumoniaPrevalence |
| spellingShingle | Kondwani Joseph Banda Hsin Chu Xiao Linda Kang Doresses Liu Li-Chung Pien Hsiu-Ju Jen Shu-Tai Shen Hsiao Kuei-Ru Chou Prevalence of dysphagia and risk of pneumonia and mortality in acute stroke patients: a meta-analysis BMC Geriatrics Acute Stroke Dysphagia Mortality Pneumonia Prevalence |
| title | Prevalence of dysphagia and risk of pneumonia and mortality in acute stroke patients: a meta-analysis |
| title_full | Prevalence of dysphagia and risk of pneumonia and mortality in acute stroke patients: a meta-analysis |
| title_fullStr | Prevalence of dysphagia and risk of pneumonia and mortality in acute stroke patients: a meta-analysis |
| title_full_unstemmed | Prevalence of dysphagia and risk of pneumonia and mortality in acute stroke patients: a meta-analysis |
| title_short | Prevalence of dysphagia and risk of pneumonia and mortality in acute stroke patients: a meta-analysis |
| title_sort | prevalence of dysphagia and risk of pneumonia and mortality in acute stroke patients a meta analysis |
| topic | Acute Stroke Dysphagia Mortality Pneumonia Prevalence |
| url | https://doi.org/10.1186/s12877-022-02960-5 |
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