Pathway analysis of the impact of dysphagia on the prognosis of patients with stroke: based on structural equation modeling.

IF 2.9 Q3 NUTRITION & DIETETICS

Clinical nutrition ESPEN Pub Date : 2024-12-27 DOI:10.1016/j.clnesp.2024.12.017

Liu Huan, Hou Yutong, Shi Jiajia, Liu Wenbo, Zhang Pingping

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Abstract

Background and aims: Dysphagia is significantly correlated with prognostic outcomes in patients with stroke; however, the intrinsic mechanism of action between the two remains unclear. This study aimed to model the intrinsic mechanism of action between dysphagia and prognostic outcomes in patients with stroke based on structural equation modeling.

Methods: A retrospective analysis of 900 inpatients with stroke from three large hospitals was performed. AMOS software (version 23.0) was used to construct the structural equation modeling.

Results: The overall model showed a good fit (chi-square = 27.3, root mean square error of approximation = 0.01, standardized root mean square residual = 0.032, comparative fit index = 0.98, and adjusted goodness of fit = 0.94). Structural equation modeling showed that the total effect of dysphagia on the prognosis of patients with stroke was 0.694, with a direct effect of 0.599, accounting for 86.31% of the total effect. The total indirect effect was 0.095, with the mediating effects of serum albumin level and pneumonia accounting for 6.48% and 7.35% of the total effect, respectively. The moderating effects of sex on dysphagia and the relationship between activities of daily living, modified Rankin scale score, and length of hospital stay were insignificant (ΔR2 = 0.063, P = 0.145; ΔR2 = 0.002, P = 0.620; ΔR2 = 0.001, P = 0.307).

Conclusions: Dysphagia can directly affect the prognostic outcomes of patients with stroke and indirectly affect prognosis by triggering pneumonia and lowering albumin levels. Sex was not found to play a moderating role in the relationship between dysphagia and prognosis.

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来源期刊

Clinical nutrition ESPEN NUTRITION & DIETETICS-

CiteScore

4.90

自引率

3.30%

发文量

512

期刊介绍： Clinical Nutrition ESPEN is an electronic-only journal and is an official publication of the European Society for Clinical Nutrition and Metabolism (ESPEN). Nutrition and nutritional care have gained wide clinical and scientific interest during the past decades. The increasing knowledge of metabolic disturbances and nutritional assessment in chronic and acute diseases has stimulated rapid advances in design, development and clinical application of nutritional support. The aims of ESPEN are to encourage the rapid diffusion of knowledge and its application in the field of clinical nutrition and metabolism. Published bimonthly, Clinical Nutrition ESPEN focuses on publishing articles on the relationship between nutrition and disease in the setting of basic science and clinical practice. Clinical Nutrition ESPEN is available to all members of ESPEN and to all subscribers of Clinical Nutrition.