Characteristics of post-stroke dysphagia: A retrospective study based on FEES.

Abstract

This study aims to examine the characteristics of dysphagia in stroke patients with different lesion sites and explore the factors that impact the duration of nasogastric tube after post-stroke dysphagia (PSD). Patients with PSD were screened for analysis. Stroke types and lesion sites were confirmed using MRI or CT scans. Included patients were categorized into two groups: supratentorial stroke group (including lobar and deep intracerebral stroke subgroups) and infratentorial stroke group (including brainstem and cerebellar stroke subgroups). Fiberoptic endoscopic evaluation of swallowing (FEES), Penetration-aspiration scale (PAS), Yale pharyngeal residue (PR) severity rating scale, Functional oral intake scale (FOIS), Murray secretion severity rating scale (MSS), laryngopharyngeal sensation, and vocal fold mobility were investigated to assess the swallowing function. A total of 94 patients were included in the final analysis. Significant differences were found in PR scores (p<.001), PAS scores (p<.05), MSS scores (p<.05), and vocal fold mobility (p<.001) between infratentorial and supratentorial stroke groups. Moreover, lobar stroke showed significantly higher PR scores compared to the deep intracerebral stroke group (p<.05). Kaplan-Meier survival analysis indicated significant differences in the duration of nasogastric tube placement among the following groups: infratentorial versus supratentorial stroke, PAS ≤ 5versus PAS>5, PR ≥ 3versus PR<3, and normal vocal fold mobility versus vocal fold motion impairment group (p<.05). The infratentorial stroke may lead to worse swallowing function as compared to a supratentorial stroke. Additionally, patients with infratentorial stroke, PAS>5, PR ≥ 3, or vocal fold motion impairment may contribute to a longer duration of nasogastric tube placement.