Analysis of Risk Factors Associated With Aspiration in Patients With Poststroke Dysphagia: A Real-World Study

Area of Science:

• Neurology
• Gastroenterology
• Clinical Medicine

Background:

• Aspiration is a severe complication of dysphagia in poststroke patients (PSD).
• Understanding risk factors for aspiration in PSD is critical for effective management.
• Current knowledge on these risk factors remains insufficient.

Purpose of the Study:

• To identify and analyze the risk factors associated with aspiration in patients experiencing poststroke dysphagia.
• To provide data for targeted interventions to reduce aspiration complications.

Main Methods:

• Retrospective analysis of 321 dysphagia patients with first-ever stroke.
• Differentiation of aspiration versus non-aspiration groups using swallowing function screening, clinical examinations, and videofluoroscopic swallowing studies.
• Multivariate logistic regression analysis of demographic, disease-related, and clinical characteristics.

Main Results:

• Risk factors for aspiration included age ≥ 65 years, history of pneumonia, severe dysarthria, >2 chronic diseases, bilateral brain injury, brainstem lesion location, and higher water swallowing test (WST) scores.
• Protective factors against aspiration were high Montreal Cognitive Assessment (MoCA) scores and high repetitive saliva swallowing test (RSST) cut-off values.

Conclusions:

• Patients aged 65 and older, with a history of pneumonia, severe dysarthria, multiple chronic conditions, bilateral brain injuries, brainstem lesions, or high WST scores require prioritized aspiration assessment and intervention.
• Cognitive function (MoCA) and saliva swallowing tests (RSST) may offer protective insights.