■吞咽困难是中风后常见的并发症,这不仅会带来不良后果,而且会极大地影响患者的生活质量。目前,没有系统评价或荟萃分析来全面评估卒中后吞咽困难(PSD)的流行病学特征.对患病率的系统回顾,危险因素,PSD的预后至关重要。
■到2022年12月31日,对与PSD相关的观察性研究进行了全面的文献检索。检索了五个数据库。随机效应模型用于估计合并患病率,比值比(OR),和95%CIs。
■共纳入34项研究,结果显示,PSD的总体患病率为46.6%(95%CI,0.405-0.528)。缺血性卒中和出血性卒中的吞咽困难发生率分别为43.6%(95%CI0.370-0.501)和58.8%(95%CI0.519-0.654),分别。非洲PSD的患病率为49.4%(95%CI,0.196-0.792),亚洲为40.1%(95%CI,0.348-0.454),欧洲为45.8%(95%CI,0.327-0.590),北美为44.3%(95%CI,0.370-0.517),南美为57.5%(95%CI,0.441-0.708),大洋洲为64.1%(95CI,0.558,0.724)。在风险因素分析中,高血压,以前的行程,房颤与PSD的发生显著相关,合并OR=1.179[(95%CI,1.002-1.386),p<0.05],合并OR=1.514[(95%CI,1.204-1.905),p<0.001],合并OR=1.980[(95%CI,1.580-2.481),p<0.001]。在结果研究中,PSD中失语和构音障碍的患病率为35.6%(95%CI,0.213-0.499)和54.5%(95%CI,0.293-0.798),分别。呼吸道感染患病率为27.1%(95CI,-0.038-0.579),肺炎的患病率为32.1%(95%CI,0.224-0.418)。出院时和1个月时吞咽困难的持续性为74.5%(95%CI,0.621-0.869)和50.9%(95%CI,0.142-0.876),分别。PSD患者入院及出院1个月时的死亡率,3个月,1年为11.8%(95%CI,0.083-0.152),26.5%(95%CI,0.170-0.359),25.7%(95%CI,0.19-0.324),和31.3%(95%CI,0.256-0.369),分别。
■这项研究发现,PSD的总体患病率为46.6%。患病率受诊断方法的影响最大。高血压,中风史,心房颤动,患者年龄,和卒中严重程度是与PSD显著相关的危险因素。失语症的患病率,构音障碍,呼吸道感染,PSD患者的肺炎是无PSD患者的2-4倍。系统审查注册:www。crd.约克。AC.英国/PROSPERO,PROSPERO,CRD42021252967。
UNASSIGNED: Dysphagia is a common complication after stroke, which not only brings adverse outcomes but also greatly affects the quality of life of patients. At present, there is no systematic review or meta-analysis to comprehensively evaluate the epidemiological characteristics of post-stroke
dysphagia (PSD). A systematic review of the prevalence, risk factors, and prognosis of PSD is essential.
UNASSIGNED: Through 31 December 2022, a comprehensive literature search was performed for observational studies related to PSD. Five databases were retrieved. Random-effects models were used to estimate the pooled prevalence, odds ratio (OR), and 95% CIs.
UNASSIGNED: A total of 34 studies were included, and the results showed that the overall prevalence of PSD was 46.6% (95% CI, 0.405-0.528). The prevalence of
dysphagia in ischemic stroke and hemorrhagic stroke was 43.6% (95% CI 0.370-0.501) and 58.8% (95% CI 0.519-0.654), respectively. The prevalence of PSD in Africa was 49.4% (95% CI, 0.196-0.792), in Asia was 40.1% (95% CI, 0.348-0.454), in Europe was 45.8% (95% CI, 0.327-0.590), in North America was 44.3% (95% CI, 0.370-0.517), in South America was 57.5% (95% CI, 0.441-0.708), and in Oceania was 64.1% (95%CI, 0.558, 0.724). In risk factor analysis, hypertension, previous stroke, and atrial fibrillation were significantly associated with the occurrence of PSD, pooled OR = 1.179 [(95% CI, 1.002-1.386), p < 0.05], pooled OR = 1.514 [(95% CI, 1.204-1.905), p < 0.001], and pooled OR = 1.980 [(95% CI, 1.580-2.481), p < 0.001]. In outcome studies, the prevalence of aphasia and dysarthria in PSD was 35.6% (95% CI, 0.213-0.499) and 54.5% (95% CI, 0.293-0.798), respectively. The prevalence of respiratory tract infection was 27.1% (95%CI, -0.038-0.579), and the prevalence of pneumonitis was 32.1% (95% CI, 0.224-0.418). Persistence of
dysphagia at discharge and at 1 month was 74.5% (95% CI, 0.621-0.869) and 50.9% (95% CI, 0.142-0.876), respectively. Mortality rates for PSD patients during admission and discharge at 1 month, 3 months, and 1 year were 11.8% (95% CI, 0.083-0.152), 26.5% (95% CI, 0.170-0.359), 25.7% (95% CI, 0.19-0.324), and 31.3% (95% CI, 0.256-0.369), respectively.
UNASSIGNED: This study found that the overall prevalence of PSD was 46.6%. Prevalence is most influenced by the diagnosis method. Hypertension, history of stroke, atrial fibrillation, patient age, and stroke severity were risk factors significantly associated with PSD. The prevalence of aphasia, dysarthria, respiratory tract infection, and pneumonitis in PSD patients is 2-4 times that of patients without PSD.Systematic review registration: www.crd.york.ac.uk/PROSPERO, PROSPERO, CRD42021252967.