Vocal fold motion impairment following stroke: SPARCS database analysis

Vocal fold motion impairment (VFMI) has been reported as a complication of stroke worldwide. However, the incidence and risk factors are unknown. This study aimed to assess the incidence and associated risk factors of post-stroke VFMI.

A query of the 2016-2023 New York State SPARCS database was performed using ICD-10 codes for adult patients with cerebral infarction (I63.x), intracerebral hemorrhage (I61.x), or subarachnoid hemorrhage (I60.x). Chi-square with post-hoc column proportion testing was performed for univariate analysis of patient demographics and comorbidities. Multivariable logistic regression analysis was used to determine odd ratios of developing VFMI after stroke controlling for patient demographics and comorbidities.

A total of 417,149 stroke patients were isolated. The number of patients diagnosed with VFMI after stroke was 1,473 (0.4%). Times to diagnosis of VFMI were within admission for stroke, 674 (45.9%); within 1 year, 457 (31.1%); between 1 and 2 years, 146 (9.9%); and more than 2 years: 192 (13.1%). Unilateral VFMI was most common, with 969 patients (65.8%), followed by unspecified VFMI, with 315 patients (21.4%), and lastly bilateral VFMI with 189 patients (12.8%). Multivariate analysis showed that VFMI patients have an increased odds ratio having chronic pulmonary disease (OR 1.32; p < 0.001) and having coagulation disorders (OR 1.49; p < 0.001).

VFMI is a rare complication after stroke, affecting 0.4% of patients. More research is needed to understand the risk factors that place patients at a higher risk of VFMI following stroke and aid in early screening/intervention.