Abstract:
The objective of this systematic review was to determine the prevalence of dysphagia and aspiration in people with progressive supranuclear palsy (PSP). A search of six electronic databases was performed from inception to April 2022. No context restrictions were set. All primary research comprising figures to derive a prevalence rate were included. Two independent reviewers screened search results. Data were extracted by one reviewer. Conflicts were resolved by discussion with a third reviewer. The quality of included studies was assessed using the JBI Checklist for Prevalence Studies. From 877 studies, 12 were eligible for inclusion. Dysphagia had to be confirmed using instrumental assessments, clinical swallowing evaluation, screening, and patient-reported outcome measures (PROM). A random-effects meta-analysis calculated a pooled dysphagia prevalence in 78-89% (95% CI [60.6, 89.1], [78.9, 95.0]). depending on the chosen assessment method, and a pooled aspiration prevalence of 23.5% (95% CI [14.5, 33.7]). The included studies were of moderate quality, with high risk of selection and coverage bias and low to moderate risk of measurement bias. Dysphagia is highly prevalent in a sample of participants with mostly moderately severe PSP. Aspiration occurs in a quarter of this sample and is likely to increase as the disease progresses. Given the low general prevalence of PSP, studies remain at high risk for selection bias. Prospective research should focus on the development of dysphagia in the course of PSP and its subcategories using instrumental assessment and consider all phases of swallowing. REGISTRATION: The protocol of this systematic review was registered on the International Prospective Register of Systematic Reviews (PROSPERO) in April 2021 (registration number: CRD42021245204).
摘要:
这项系统评价的目的是确定进行性核上性麻痹(PSP)患者吞咽困难和误吸的发生率。从成立到2022年4月,对六个电子数据库进行了搜索。未设置上下文限制。包括得出患病率的所有主要研究。两名独立的审阅者筛选了搜索结果。数据由一名审阅者提取。通过与第三位审阅者的讨论解决了冲突。纳入研究的质量使用JBI患病率研究清单进行评估。从877项研究中,12人符合入选条件。吞咽困难必须使用仪器评估来确认,临床吞咽评估,筛选,和患者报告的结局指标(PROM)。一项随机效应荟萃分析计算了78-89%的合并吞咽困难患病率(95%CI[60.6,89.1],[78.9,95.0]).根据所选择的评估方法,合并误吸患病率为23.5%(95%CI[14.5,33.7])。纳入的研究质量中等,选择和覆盖偏差的风险较高,测量偏差的风险低至中等。吞咽困难在大多数患有中度重度PSP的参与者样本中非常普遍。误吸发生在该样本的四分之一中,并且可能随着疾病的进展而增加。鉴于PSP的普遍患病率较低,研究仍然存在选择偏倚的高风险。前瞻性研究应使用仪器评估将重点放在PSP及其子类别过程中吞咽困难的发展上,并考虑吞咽的所有阶段。注册:本系统审查的方案于2021年4月在国际前瞻性系统审查注册(PROSPERO)上注册(注册号:CRD42021245204)。