Research on Relationship Between Dysphagia and Sudden Death After Medullary Infarction.

Abstract

Medullary infarction (MI) often leads to severe dysphagia and sudden death. We investigated whether dysphagia was associated with sudden death. Patients with MI were divided into sudden death group and nonsudden death group. Dysphagia was evaluated in 2 ways: the water-swallowing test (WST) points and the degree of dysphagia. Random undersampling (RUS), random oversampling (ROS), and synthetic minority oversampling technique (SMOTE) techniques were used to process the original data and solve the imbalance problem between 2 classes. Univariate and multivariate logistic regressions were used to analyze the association between the independent variables (WST and degree of dysphagia) and the dependent variable (sudden death or not), while the National Institutes of Health Stroke Scale (NIHSS) score was used as a control. Univariate logistic regression analysis showed that for all resampling methods, both the WST and NIHSS were risk factors for sudden death after MI. For multivariable logistic regression, the fitting effect of RUS logistic regression was satisfactory, which showed the same results. The results of the univariate logistic regression analysis of dysphagia degree showed that for all resampling methods, compared with no dysphagia, both mild to moderate dysphagia degree and severe dysphagia degree were risk factors for sudden death. For multivariable logistic regressions, the logistic regressions of the original data and the RUS resampling method were satisfactory which showed the same results. Dysphagia is closely related to sudden death after MI. The more severe the dysphagia, the higher is the incidence of sudden death.