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Observational Study
. 2024 Sep 28;24(1):358.
doi: 10.1186/s12883-024-03863-1.

Comorbidities associated with dysphagia after acute ischemic stroke

Anel Karisik  1   2 , Vincent Bader  2 , Kurt Moelgg  1   2 , Lucie Buergi  1   2 , Benjamin Dejakum  2 , Silvia Komarek  2 , Michael Thomas Eller  2 , Thomas Toell  2 , Lukas Mayer-Suess  2 , Raimund Pechlaner  2 , Julian Granna  1 , Simon Sollereder  1 , Sonja Rossi  3 , Gudrun Schoenherr  2 , Johann Willeit  2 , Peter Willeit  4   5 , Wilfried Lang  1   6 , Stefan Kiechl  1   2 , Michael Knoflach  7   8 , Christian Boehme  9 ; STROKE-CARD study group
Collaborators, Affiliations
Observational Study

Comorbidities associated with dysphagia after acute ischemic stroke

Anel Karisik et al. BMC Neurol. .

Abstract

Background: Pre-existing comorbidities increase the likelihood of post-stroke dysphagia. This study investigates comorbidity prevalence in patients with dysphagia after ischemic stroke.

Methods: The data of patients with acute ischemic stroke from two large representative cohorts (STROKE-CARD trial 2014-2019 and STROKE-CARD registry 2020-2022 - both study center Innsbruck, Austria) were analyzed for the presence of dysphagia at hospital admission (clinical swallowing examination). Comorbidities were assessed using the Charlson Comorbidity Index (CCI).

Results: Of 2054 patients with ischemic stroke, 17.2% showed dysphagia at hospital admission. Patients with dysphagia were older (77.8 ± 11.9 vs. 73.6 ± 14.3 years, p < 0.001), had more severe strokes (NIHSS 7(4-12) vs. 2(1-4), p < 0.001) and had higher CCI scores (4.7 ± 2.1 vs. 3.8 ± 2.0, p < 0.001) than those without swallowing impairment. Dysphagia correlated with hypertension (p = 0.034), atrial fibrillation (p < 0.001), diabetes (p = 0.002), non-smoking status (p = 0.014), myocardial infarction (p = 0.002), heart failure (p = 0.002), peripheral arterial disease (p < 0.001), severe chronic liver disease (p = 0.002) and kidney disease (p = 0.010). After adjusting for relevant factors, the associations with dysphagia remained significant for diabetes (p = 0.005), peripheral arterial disease (p = 0.007), kidney disease (p = 0.014), liver disease (p = 0.003) and overall CCI (p < 0.001).

Conclusions: Patients with multiple comorbidities have a higher risk of developing post-stroke dysphagia. Therefore, early and thorough screening for swallowing impairment after acute ischemic stroke is crucial especially in those with multiple concomitant diseases.

Trial registration: Stroke Card Registry (NCT04582825), Stroke Card Trial (NCT02156778).

Keywords: Comorbidities; Dysphagia; Ischemic stroke; Risk factors; Swallowing impairment.

PubMed Disclaimer

Conflict of interest statement

PW reports consultancy fees from Novartis Pharmaceuticals unrelated to this manuscript. None of the other authors reported conflicts of interest relevant to this work.

Figures

Fig. 1
Fig. 1
Study flow-chart (Study center Innsbruck)
See this image and copyright information in PMC

References

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