Health Factors Associated With Development and Severity of Poststroke Dysphagia: An Epidemiological Investigation
Background Dysphagia after stroke is common and can impact morbidity and death. The purpose of this population‐based study was to determine specific epidemiological and health risk factors that impact development of dysphagia after acute stroke. Methods and Results Ischemic and hemorrhagic stroke ca...
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| Format: | Article |
| Language: | English |
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Wiley
2024-04-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.123.033922 |
| _version_ | 1797229270985080832 |
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| author | Brittany N. Krekeler Heidi J. P. Schieve Jane Khoury Lili Ding Mary Haverbusch Kathleen Alwell Opeolu Adeoye Simona Ferioloi Jason Mackey Daniel Woo Matthew Flaherty Felipe De Los Rios La Rosa Stacie Demel Michael Star Elisheva Coleman Kyle Walsh Sabreena Slavin Adam Jasne Eva Mistry Dawn Kleindorfer Brett Kissela |
| author_facet | Brittany N. Krekeler Heidi J. P. Schieve Jane Khoury Lili Ding Mary Haverbusch Kathleen Alwell Opeolu Adeoye Simona Ferioloi Jason Mackey Daniel Woo Matthew Flaherty Felipe De Los Rios La Rosa Stacie Demel Michael Star Elisheva Coleman Kyle Walsh Sabreena Slavin Adam Jasne Eva Mistry Dawn Kleindorfer Brett Kissela |
| author_sort | Brittany N. Krekeler |
| collection | DOAJ |
| description | Background Dysphagia after stroke is common and can impact morbidity and death. The purpose of this population‐based study was to determine specific epidemiological and health risk factors that impact development of dysphagia after acute stroke. Methods and Results Ischemic and hemorrhagic stroke cases from 2010 and 2015 were identified via chart review from the GCNKSS (Greater Cincinnati Northern Kentucky Stroke Study), a representative sample of ≈1.3 million adults from southwestern Ohio and northern Kentucky. Dysphagia status was determined on the basis of clinical assessments and necessity for alternative access to nutrition via nasogastric or percutaneous endoscopic gastrostomy tube placement. Comparisons between patients with and without dysphagia were made to determine differences in baseline characteristics and premorbid conditions. Multivariable logistic regression determined factors associated with increased risk of dysphagia. Dysphagia status was ascertained from 4139 cases (1709 with dysphagia). Logistic regression showed that increased age, Black race, higher National Institutes of Health Stroke Scale score at admission, having a hemorrhagic stroke (versus infarct), and right hemispheric stroke increased the risk of developing dysphagia after stroke. Factors associated with reduced risk included history of high cholesterol, lower prestroke modified Rankin Scale score, and white matter disease. Conclusions This study replicated previous findings of variables associated with dysphagia (older age, worse stroke, right‐sided hemorrhagic lesions), whereas other variables identified were without clear biological rationale (eg, Black race, history of high cholesterol, and presence of white matter disease) and should be investigated in future studies to determine biological relevance and potential influence in stroke recovery. |
| first_indexed | 2024-04-24T15:09:56Z |
| format | Article |
| id | doaj.art-b868def4cce54ce1af4e04c812a1acf0 |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-04-24T15:09:56Z |
| publishDate | 2024-04-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-b868def4cce54ce1af4e04c812a1acf02024-04-02T11:49:51ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802024-04-0113710.1161/JAHA.123.033922Health Factors Associated With Development and Severity of Poststroke Dysphagia: An Epidemiological InvestigationBrittany N. Krekeler0Heidi J. P. Schieve1Jane Khoury2Lili Ding3Mary Haverbusch4Kathleen Alwell5Opeolu Adeoye6Simona Ferioloi7Jason Mackey8Daniel Woo9Matthew Flaherty10Felipe De Los Rios La Rosa11Stacie Demel12Michael Star13Elisheva Coleman14Kyle Walsh15Sabreena Slavin16Adam Jasne17Eva Mistry18Dawn Kleindorfer19Brett Kissela20Department of Otolaryngology‐Head and Neck Surgery University of Cincinnati College of Medicine Cincinnati OH USAWake Forest School of Medicine Winston‐Salem NC USADivision of Biostatistics and Epidemiology, Cincinnati Children’s Hospital Medical Center, Department of Pediatrics University of Cincinnati College of Medicine Cincinnati OH USADivision of Biostatistics and Epidemiology, Cincinnati Children’s Hospital Medical Center, Department of Pediatrics University of Cincinnati College of Medicine Cincinnati OH USADepartment of Neurology and Rehabilitation Medicine University of Cincinnati College of Medicine Cincinnati OH USADepartment of Neurology and Rehabilitation Medicine University of Cincinnati College of Medicine Cincinnati OH USADepartment of Emergency Medicine Washington University School of Medicine St. Louis MO USADepartment of Neurology and Rehabilitation Medicine University of Cincinnati College of Medicine Cincinnati OH USADepartment of Neurology Indiana University School of Medicine Indianapolis IN USADepartment of Neurology and Rehabilitation Medicine University of Cincinnati College of Medicine Cincinnati OH USADepartment of Neurology and Rehabilitation Medicine University of Cincinnati College of Medicine Cincinnati OH USADepartment of Neurology and Rehabilitation Medicine University of Cincinnati College of Medicine Cincinnati OH USADepartment of Neurology and Rehabilitation Medicine University of Cincinnati College of Medicine Cincinnati OH USASorkoa Medical Center Beersheva IsraelDepartment of Neurology University of Chicago Medicine Chicago IL USADepartment of Neurology and Rehabilitation Medicine University of Cincinnati College of Medicine Cincinnati OH USADepartment of Neurology University of Kansas Medical Center Kansas City KS USADepartment of Neurology Yale School of Medicine New Haven CT USADepartment of Neurology and Rehabilitation Medicine University of Cincinnati College of Medicine Cincinnati OH USADepartment of Neurology and Rehabilitation Medicine University of Cincinnati College of Medicine Cincinnati OH USADepartment of Neurology and Rehabilitation Medicine University of Cincinnati College of Medicine Cincinnati OH USABackground Dysphagia after stroke is common and can impact morbidity and death. The purpose of this population‐based study was to determine specific epidemiological and health risk factors that impact development of dysphagia after acute stroke. Methods and Results Ischemic and hemorrhagic stroke cases from 2010 and 2015 were identified via chart review from the GCNKSS (Greater Cincinnati Northern Kentucky Stroke Study), a representative sample of ≈1.3 million adults from southwestern Ohio and northern Kentucky. Dysphagia status was determined on the basis of clinical assessments and necessity for alternative access to nutrition via nasogastric or percutaneous endoscopic gastrostomy tube placement. Comparisons between patients with and without dysphagia were made to determine differences in baseline characteristics and premorbid conditions. Multivariable logistic regression determined factors associated with increased risk of dysphagia. Dysphagia status was ascertained from 4139 cases (1709 with dysphagia). Logistic regression showed that increased age, Black race, higher National Institutes of Health Stroke Scale score at admission, having a hemorrhagic stroke (versus infarct), and right hemispheric stroke increased the risk of developing dysphagia after stroke. Factors associated with reduced risk included history of high cholesterol, lower prestroke modified Rankin Scale score, and white matter disease. Conclusions This study replicated previous findings of variables associated with dysphagia (older age, worse stroke, right‐sided hemorrhagic lesions), whereas other variables identified were without clear biological rationale (eg, Black race, history of high cholesterol, and presence of white matter disease) and should be investigated in future studies to determine biological relevance and potential influence in stroke recovery.https://www.ahajournals.org/doi/10.1161/JAHA.123.033922dysphagiafeedingstrokeswallowing |
| spellingShingle | Brittany N. Krekeler Heidi J. P. Schieve Jane Khoury Lili Ding Mary Haverbusch Kathleen Alwell Opeolu Adeoye Simona Ferioloi Jason Mackey Daniel Woo Matthew Flaherty Felipe De Los Rios La Rosa Stacie Demel Michael Star Elisheva Coleman Kyle Walsh Sabreena Slavin Adam Jasne Eva Mistry Dawn Kleindorfer Brett Kissela Health Factors Associated With Development and Severity of Poststroke Dysphagia: An Epidemiological Investigation Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease dysphagia feeding stroke swallowing |
| title | Health Factors Associated With Development and Severity of Poststroke Dysphagia: An Epidemiological Investigation |
| title_full | Health Factors Associated With Development and Severity of Poststroke Dysphagia: An Epidemiological Investigation |
| title_fullStr | Health Factors Associated With Development and Severity of Poststroke Dysphagia: An Epidemiological Investigation |
| title_full_unstemmed | Health Factors Associated With Development and Severity of Poststroke Dysphagia: An Epidemiological Investigation |
| title_short | Health Factors Associated With Development and Severity of Poststroke Dysphagia: An Epidemiological Investigation |
| title_sort | health factors associated with development and severity of poststroke dysphagia an epidemiological investigation |
| topic | dysphagia feeding stroke swallowing |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.123.033922 |
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