Muscle, Nutritional, and Videofluoroscopic Factors Associated With 6-Month Oral Intake Recovery in Post-Stroke Dysphagia
Seongmin Choi, Seung Don Yoo, Dong Hwan Kim, Seung Ah Lee, Sung Joon Chung, Eo Jin ParkObjective:
To determine whether muscle, nutritional, and videofluoroscopic factors were associated with 6-month oral intake recovery after stroke.
Design:
This single-center retrospective cohort study included 1,286 adults with ischemic or hemorrhagic stroke, oropharyngeal dysphagia, baseline Functional Oral Intake Scale (FOIS) scores of 1 to 4, and index videofluoroscopy within 180 days of stroke onset. The primary analysis was restricted to the 1,241 patients alive at 6 months. Successful oral intake recovery was defined as achievement of total oral intake with multiple consistencies (FOIS ≥5) at 180±30 days; death before 6 months was analyzed separately.
Results:
Among 1,241 six-month survivors, 748 (60.3%) achieved successful oral intake recovery. Lower odds of recovery were associated with low skeletal muscle mass index (adjusted odds ratio, 0.67; 95% confidence interval, 0.50-0.90), low grip strength (0.69; 0.51-0.92), Geriatric Nutritional Risk Index less than 98 (0.75; 0.56-1.00), Penetration-Aspiration Scale score of 6 or higher (0.60; 0.43-0.83), moderate or severe vallecular residue (0.65; 0.49-0.85), and moderate or severe pyriform sinus residue (0.57; 0.42-0.77).
Conclusion:
Videofluoroscopic swallowing findings and indirect systemic vulnerability markers provided complementary information regarding 6-month oral intake recovery among stroke survivors after adjustment for stroke severity, cognition, aphasia, lesion characteristics, and major comorbidities.