Influential factors analysis of swallowing function after stroke based on videofluoroscopic dysphagia scale assessment:A retrospective study
10.3969/j.issn.1001-1242.2025.03.004
- VernacularTitle:基于吞咽障碍造影评分量表半定量评估法的脑卒中后吞咽功能相关影响因素分析
- Author:
Min FENG
1
;
Fang CONG
;
Qian LU
Author Information
1. 南京医科大学附属江苏盛泽医院,江苏省苏州市,215228
- Publication Type:Journal Article
- Keywords:
stroke;
swallowing disorder;
influencing factors;
videofluoroscopic dysphagia scale
- From:
Chinese Journal of Rehabilitation Medicine
2025;40(3):343-348,355
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the influencing factors of swallowing function after stroke based on the semi-quantita-tive assessment of the videofluoroscopic dysphagia scale(VDS),to provide a basis for clinical screening and treatment.Method:A retrospective survey method was conducted on 120 stroke patients who met the inclusion criteria.Clinical characteristics were collected,including gender,age,type of stroke,lesion location,disease duration,food consistency,nasogastric tube placement,tracheostomy,and comorbidities.All patients underwent a video-fluoroscopic swallowing study(VFSS),and swallowing function was assessed using the videofluoroscopic dys-phagia scale(VDS).Univariate and multivariate linear regression analyses were conducted to examine the ef-fects of clinical characteristics on oral phase,pharyngeal phase,and global swallowing function.Result:Univariate analysis revealed that subcortical lesions in the middle cerebral artery(MCA)region(ex-cluding the basal ganglia)(P<0.001),basal ganglia lesions(P=0.040),and medullary lesions(P<0.001)were significantly associated with global swallowing function after stroke.Multivariate linear regression analysis indi-cated that medullary lesions(P<0.001),subcortical lesions in the MCA region(excluding the basal ganglia)(P<0.001),and MCA(including basal ganglia)lesions(P=0.019)were risk factors for global swallowing function after stroke.Regarding food consistency,consumption of thickened liquids(P=0.018)and pureed foods(P=0.006)were protective factors for global swallowing function.Subgroup analysis of global swallow-ing function revealed that MCA(including basal ganglia)lesions(P=0.003),female gender(P<0.001)and tra-cheotomy(P<0.001)were risk factors for oral phase swallowing function after stroke.Compared with patients without a gastrostomy tube,those with a gastrostomy tubes(P=0.034)had less effect on swallowing function in the oral phase.Compared with hemorrhagic stroke,ischemic stroke(P<0.001)had a less impact on the oral phase swallowing function.Medullary lesions(P<0.001)and subcortical lesions in the MCA region(ex-cluding the basal ganglia)(P<0.001)were risk factors for pharyngeal phase swallowing function.For food con-sistency,the consumption of thickened liquids(P=0.005)and pureed foods(P=0.002)were protective factors for pharyngeal phase swallowing function after stroke.Conclusion:Identifying clinical characteristics in the assessment of swallowing function in stroke patients helps to determine the type of dysphagia and the key points of treatment.This approach may facilitate the de-velopment and implementation of more targeted rehabilitation treatment plans,and accelerate the recovery of swallowing function and feeding ability in stroke patients.