Dataset Information

Dysphagia and associated factors among patients with acute ischemic stroke in Vietnam.

ABSTRACT:

Background

Dysphagia is considered an important issue in managing and treating acute stroke, but there are currently no studies investigating this issue, especially for patients with acute ischemic stroke in Vietnam. Thus, we conducted this study to determine the prevalence of dysphagia and associated factors of dysphagia in patients with acute ischemic stroke in Vietnam.

Materials and methods

From June 2020 to January 2022, a cross-sectional study of patients with acute ischemic stroke was conducted in a tertiary hospital in Vietnam. The dysphagia was evaluated through a bedside screening test using the Gugging Swallowing Screen (GUSS). Factors associated with dysphagia were analysed using univariate and multivariate logistic regression.

Results

The prevalence of dysphagia in patients with acute ischemic stroke was 71.6%, in which the mild, moderate and severe dysphagia accounted for 37.5%, 12.4% and 21.7%, respectively. Dysphagia significantly associated with age group 50-59 (OR = 2.2, 95% CI: 1.2-4.2), age group 60-69 (OR = 1.9, 95% CI: 1.04-3.4), age group >70 (OR = 2.2, 95% CI: 1.2-4.2), brainstem (OR = 4.0, 95% CI: 2.1-7.4), having communication disorder (OR = 1.5, 95% CI: 1.1-7.4) and having facial paralysis (OR = 17.9, 95% CI: 12.0-26.8).

Conclusion

Our study showed that the prevalence of dysphagia is high among patients with acute ischemic stroke in Vietnam. Intervention solutions should focus more on patient groups of higher age group, brainstem stroke, communication disorder and facial paralysis.

SUBMITTER: Thu Hien NT

PROVIDER: S-EPMC9758358 | biostudies-literature | 2022 Dec

REPOSITORIES: biostudies-literature

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Publications

Dysphagia and associated factors among patients with acute ischemic stroke in Vietnam.

Thu Hien Nguyen Thi NT Thong Tran Huu TH Tung Le Thanh LT Khoi Vo Hong VH Thu Hoai Dao Thi DT Tinh Tran Thi TT Van Huy Nguyen N Kien Vu Duy VD

Annals of medicine and surgery (2012) 20221116

<h4>Background</h4>Dysphagia is considered an important issue in managing and treating acute stroke, but there are currently no studies investigating this issue, especially for patients with acute ischemic stroke in Vietnam. Thus, we conducted this study to determine the prevalence of dysphagia and associated factors of dysphagia in patients with acute ischemic stroke in Vietnam.<h4>Materials and methods</h4>From June 2020 to January 2022, a cross-sectional study of patients with acute ischemic ...[more]

PMID: 36536715

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Project description:Background and purpose: Early recognition and management of post-stroke dysphagia (PSD) based on MRI may reduce the incidence of complications. Combining clinical symptoms with applications of MRI, we aimed to identify the risk factors of PSD, develop a prediction scale with high accuracy and map key dysphagia brain areas. Methods: A total of 275 acute ischemic stroke patients were enrolled in this study, and 113 (41.1%) patients were diagnosed with PSD. All patients underwent the water-swallowing test (WST) and volume-viscosity swallow test (V-VST) within first 24 h following admission to assess swallowing. Vascular factors were evaluated and MRI brain scans were obtained within 3 days after symptom onset for each participant admitted to the hospital. T-test, chi-squared test and Fisher's exact test were used to investigate the associations of various patient characteristics with dysphagia, and multivariable logistic regression models were used to construct a prediction scale. Scale accuracy was assessed using receiver operating characteristic (ROC) analysis. We extracted white matter hyperintensities for each patient as potential brain lesions. Voxel-based lesion-symptom mapping (VLSM) was used to identify key brain areas for dysphagia. Results: Risk factors related with PSD were older age, history of atrial fibrillation, higher fasting blood glucose, NIH stroke scale, TOAST classification, progressive stroke, middle cerebral artery lesion and anterior cerebral artery lesion. Three variables with most significant associations, including NIH stroke scale, TOAST classification and progressive stroke, combined with age and gender, were used to construct a dysphagia prediction scale with high accuracy (AUC = 0.86). VLSM identified left inferior parietal gyrus as a key brain region for PSD. Conclusion: Risk factors of PSD were identified and a predictive model of dysphagia was constructed intelligently and automatically. The left inferior parietal gyrus was identified as a key brain area for dysphagia, which provides a new symptom-based treatment target for early rehabilitation in the future.

Project description:Aim of the present study is to identify all circulating miRNAs that are modulated in patients with stroke, to select specific miRNAs to be used as disease biomarkers to improve both diagnosis and prognosis. Background. Stroke is the second-most common cause of death worldwide. The major factor limiting prognosis in patients affected by acute stroke is the very limited therapeutic window, so that most patients are not able receive the most successful treatments because of delays in diagnosis and to differentiate between ischemic and hemorrhagic etiology. Circulating levels of selected microRNAs (miRNAs) were found to be modulated both in animal experimental models and in patients with stroke, opening up new avenues for the identification of more effective and specific biomarkers to identify and risk-stratify stroke patients. Study aim. Aim of the present study is to identify all circulating miRNAs that are modulated in patients with stroke, to select specific miRNAs to be used as disease biomarkers to improve both diagnosis and prognosis. Methods. RNA was extracted from plasma samples using a commercial RNA extraction kit and quality of extracted material was assessed using a fluorometric electrophoretic assay (Agilent 4200 TapeStation, Santa Clara, CA, USA). MiRNA profiling was performed using the Affymetrix platform using GeneChip 4.0 (Thermo Fischer Scientific, Waltham, MA, USA). RT-PCR was performed using the Taqman protocol. MiRNA were chosen among those with the most relevant modulation between the groups. Results. Among the circulating miRNAs that were most down-regulated in stroke patients, we identified miR-3135b (20-fold, p<0.001), associated with vascular calcifications and heart failure; miR-1275 (18-fold, p=0.028), involved in cardiovascular atherosclerotic diseases and a sponge for circMAN2B2 in cancer; miR-4467 (13-fold, p=0.003), modulated in neurodegenerative diseases; and miR-7170 (7-fold, p<0.001). Among the circulating miRNAs that were most up-regulated in stroke patients, we identified miR-18a (35-fold, p=0.004), associated with stroke in the Framingham Cohort; the platelet-enriched miR-22-5p (24-fold, p=0.004), that is modulated in Huntington Disease; miR-199a (11-fold, p=0.012), a marker of brain microvascular injury and of stroke severity in rats, and miR-106b (10-fold, p=0.009), a regulator of neural stem-cell proliferation/differentiation whose level are modulated in patients with neurodegenerative diseases. Conclusions. Our results identified several circulating miRNAs that are down- of up-regulated in stroke patients. Among those with the most relevant differential expression, several miRNAs were identified that are known to play a role in the pathophysiology of neurovascular diseases, paving the way to a new class of smart pathophysiology-based biomarkers in stroke.

Dataset Information

Dysphagia and associated factors among patients with acute ischemic stroke in Vietnam.

Background

Materials and methods

Results

Conclusion

Publications

Dysphagia and associated factors among patients with acute ischemic stroke in Vietnam.

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