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Prevalence of dysphagia and risk of pneumonia and mortality in acute stroke patients: a meta-analysis

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 previo...

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Autores principales: Banda, Kondwani Joseph, Chu, Hsin, Kang, Xiao Linda, Liu, Doresses, Pien, Li-Chung, Jen, Hsiu-Ju, Hsiao, Shu-Tai Shen, Chou, Kuei-Ru
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9103417/
https://www.ncbi.nlm.nih.gov/pubmed/35562660
http://dx.doi.org/10.1186/s12877-022-02960-5
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author Banda, Kondwani Joseph
Chu, Hsin
Kang, Xiao Linda
Liu, Doresses
Pien, Li-Chung
Jen, Hsiu-Ju
Hsiao, Shu-Tai Shen
Chou, Kuei-Ru
author_facet Banda, Kondwani Joseph
Chu, Hsin
Kang, Xiao Linda
Liu, Doresses
Pien, Li-Chung
Jen, Hsiu-Ju
Hsiao, Shu-Tai Shen
Chou, Kuei-Ru
author_sort Banda, Kondwani Joseph
collection PubMed
description 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. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12877-022-02960-5.
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spelling pubmed-91034172022-05-14 Prevalence of dysphagia and risk of pneumonia and mortality in acute stroke patients: a meta-analysis Banda, Kondwani Joseph Chu, Hsin Kang, Xiao Linda Liu, Doresses Pien, Li-Chung Jen, Hsiu-Ju Hsiao, Shu-Tai Shen Chou, Kuei-Ru BMC Geriatr Research 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. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12877-022-02960-5. BioMed Central 2022-05-13 /pmc/articles/PMC9103417/ /pubmed/35562660 http://dx.doi.org/10.1186/s12877-022-02960-5 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Banda, Kondwani Joseph
Chu, Hsin
Kang, Xiao Linda
Liu, Doresses
Pien, Li-Chung
Jen, Hsiu-Ju
Hsiao, Shu-Tai Shen
Chou, Kuei-Ru
Prevalence of dysphagia and risk of pneumonia and mortality in acute stroke patients: a meta-analysis
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 Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9103417/
https://www.ncbi.nlm.nih.gov/pubmed/35562660
http://dx.doi.org/10.1186/s12877-022-02960-5
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