Health Factors Associated With Development and Severity of Poststroke Dysphagia: An Epidemiological Investigation

dc.contributor.authorKrekeler, Brittany N.
dc.contributor.authorSchieve, Heidi J. P.
dc.contributor.authorKhoury, Jane
dc.contributor.authorDing, Lili
dc.contributor.authorHaverbusch, Mary
dc.contributor.authorAlwell, Kathleen
dc.contributor.authorAdeoye, Opeolu
dc.contributor.authorFerioloi, Simona
dc.contributor.authorMackey, Jason
dc.contributor.authorWoo, Daniel
dc.contributor.authorFlaherty, Matthew
dc.contributor.authorDe Los Rios La Rosa, Felipe
dc.contributor.authorDemel, Stacie
dc.contributor.authorStar, Michael
dc.contributor.authorColeman, Elisheva
dc.contributor.authorWalsh, Kyle
dc.contributor.authorSlavin, Sabreena
dc.contributor.authorJasne, Adam
dc.contributor.authorMistry, Eva
dc.contributor.authorKleindorfer, Dawn
dc.contributor.authorKissela, Brett
dc.contributor.departmentNeurology, School of Medicine
dc.date.accessioned2024-09-06T14:11:33Z
dc.date.available2024-09-06T14:11:33Z
dc.date.issued2024
dc.description.abstractBackground: 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.
dc.eprint.versionFinal published version
dc.identifier.citationKrekeler BN, Schieve HJP, Khoury J, et al. Health Factors Associated With Development and Severity of Poststroke Dysphagia: An Epidemiological Investigation. J Am Heart Assoc. 2024;13(7):e033922. doi:10.1161/JAHA.123.033922
dc.identifier.urihttps://hdl.handle.net/1805/43178
dc.language.isoen_US
dc.publisherAmerican Heart Association
dc.relation.isversionof10.1161/JAHA.123.033922
dc.relation.journalJournal of the American Heart Association
dc.rightsAttribution-NonCommercial-NoDerivatives 4.0 International
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/
dc.sourcePMC
dc.subjectDysphagia
dc.subjectFeeding
dc.subjectStroke
dc.subjectSwallowing
dc.titleHealth Factors Associated With Development and Severity of Poststroke Dysphagia: An Epidemiological Investigation
dc.typeArticle
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