Relationship between Post-Stroke Cognitive Impairment and Severe Dysphagia: A Retrospective Cohort Study.
Relationship between Post-Stroke Cognitive Impairment and Severe Dysphagia: A Retrospective Cohort Study.
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脑卒中后认知功能障碍与重度吞咽困难的关系：一项回顾性队列研究。
DOI：
10.3390/brainsci12060803
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发表时间：
2022-06-19
期刊：
影响因子：
3.3
通讯作者：
Dou, Zu-Lin
中科院分区：
文献类型：
--
作者：
Qiao, Jia;Wu, Zhi-Min;Ye, Qiu-Ping;Dai, Yong;Dou, Zu-Lin
关键词：
目的：目的探讨脑卒中后认知功能障碍（PSCI）与重度卒中后吞咽困难（PSD）的关系，以及PSCI合并重度PSD的相关危险因素。方法：从康复特定疾病数据库中整理患者数据。采用简易精神状态检查量表（MMSE）、蒙特利尔认知功能评定量表（莫卡）、吞咽功能检查量表（VFSS）、穿透性误吸量表（PAS）和功能性口腔摄入量表（FOIS）评定患者的认知功能和吞咽功能。通过Pearson卡方检验（χ2）或Fisher精确检验确定组间差异。在预先规定的亚组分析中，使用Wilcoxon秩和或Kruskal-Wallis检验分析PAS和FOIS数据。危险因素采用多因素Logistic回归分析。结果：共有1555例患者被确定为PSCI。结果表明，PSCI患者重度PSD的发生率明显高于非PSCI患者（P < 0.001）。重度PSCI患者更可能临床表现为口腔期功能障碍（p = 0.024），而轻度PSCI患者主要表现为咽期功能障碍（p < 0.001）。在住院期间，各亚组之间FOIS评分变化存在显著差异（重度PSCI vs.中度PSCI和重度PSCI vs.轻度PSCI）（所有p < 0.001）。此外，多变量logistic回归显示肺炎（p < 0.001）、气管切开术（p < 0.001）和构音障碍（p = 0.006）与PSCI相关，并伴有重度PSD。结论：PSCI可能与重度PSD有关。重度PSCI患者更可能表现为口腔期功能障碍，而轻度PSCI患者则表现为咽期功能障碍。肺炎、气管切开、构音障碍是PSCI合并重度PSD的危险因素。
Objective: To investigate the relationship between post-stroke cognitive impairment (PSCI) and severe post-stroke dysphagia (PSD) and explore the risk factors related to PSCI combined with severe PSD. Methods: Data from patients were collated from the rehabilitation-specific disease database. The Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), Videofluoroscopy Swallowing Study (VFSS), Penetration-aspiration Scale (PAS), and Functional Oral Intake Scale (FOIS) were used to evaluate cognitive and swallowing functions. Differences between groups were determined by the Pearson chi-square test (χ2) or Fisher exact test. PAS and FOIS data were analyzed with the use of the Wilcoxon rank-sum or Kruskal–Wallis test in the prespecified subgroup analysis. Risk factors were investigated by multivariate logistic regression. Results: A total of 1555 patients were identified with PSCI. The results indicated that patients with PSCI had a higher incidence rate of severe PSD as compared to patients without PSCI (p < 0.001). Patients with severe PSCI were more likely to clinically manifest oral phase dysfunction (p = 0.024), while mild PSCI patients mainly manifested pharyngeal phase dysfunction (p < 0.001). There was a significant difference in FOIS score changes between subgroups during the hospitalization period (severe PSCI vs. moderate PSCI and severe PSCI vs. mild PSCI) (all p < 0.001). In addition, multivariate logistic regression revealed pneumonia (p < 0.001), tracheotomy (p < 0.001), and dysarthria (p = 0.006) were related to PSCI, combined with severe PSD. Conclusion: PSCI may be related to severe PSD. Patients with severe PSCI were more likely to manifest oral phase dysfunction, while mild PSCI manifested pharyngeal phase dysfunction. Pneumonia, tracheotomy, and dysarthria were risk factors related to PSCI combined with severe PSD.
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DOI：
10.1016/j.bbadis.2016.01.015
发表时间：
2016-05
期刊：
Biochimica et biophysica acta
影响因子：
--
作者：
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通讯作者：
Ihara M
影响因子：
25
作者：
Hamdy, S;Rothwell, JC;Thompson, DG
通讯作者：
Thompson, DG
影响因子：
1.3
作者：
Jo, Soo Yung;Hwang, Jeong-Won;Pyun, Sung-Bom
通讯作者：
Pyun, Sung-Bom
影响因子：
2.6
作者：
Holland, G.;Jayasekeran, V.;Hamdy, S.
通讯作者：
Hamdy, S.
DOI：
10.1002/hed.21903
发表时间：
2011-10-01
影响因子：
2.9
作者：
Malandraki, Georgia A.;Johnson, Sterling;Robbins, JoAnne
通讯作者：
Robbins, JoAnne