Predictors of recovery from dysphagia after stroke: A systematic review and meta-analysis

Abstract

Objective

This systematic review aimed to identify the predictors of recovery from dysphagia after stroke in the last ten years, thereby providing an evidence-based basis for nurses to identify high-risk patients and develop individualized rehabilitation plans to improve patient prognosis.

Methods

Databases including the China National Knowledge Infrastructure (CNKI), China Biology Medicine disc (CBMdisc), China Science and Technology Journal (VIP), WanFang, PubMed, Embase, CINAHL, Web of Science, the Cochrane Library, and Scopus were retrieved to search for literature on the predictors of recovery from dysphagia after stroke. The retrieval period was from January 2013 to December 2023. The quality of studies was assessed using the Newcastle-Ottawa Scale (NOS) and the Prediction model Risk of Bias Assessment Tool (PROBAST). Meta-analysis was performed using Revman5.3 and Stata15.1 software. The review protocol has been registered with PROSPERO (CRD42024605570).

Results

A total of 1,216 results were obtained, including 599 in English and 617 in Chinese. A total of 34 studies were included, involving 156,309 patients with post-stroke dysphagia, and the rate of dysphagia recovery increased from 13.53% at 1 week to 95% at 6 months after stroke. Meta-analysis results showed that older age [OR = 1.06, 95%CI (1.04, 1.08), P < 0.001], lower BMI [OR = 1.28, 95%CI (1.17, 1.40), P < 0.001], bilateral stroke [OR = 3.10, 95%CI (2.04, 4.72), P < 0.001], higher National Institutes of Health Stroke Scale (NIHSS) score [OR = 1.19, 95%CI (1.01, 1.39), P = 0.030], tracheal intubation [OR = 5.08, 95%CI (1.57, 16.39), P = 0.007] and aspiration [OR = 4.70, 95%CI (3.06, 7.20), P < 0.001] were unfavorable factors for the recovery of swallowing function in patients with post-stroke dysphagia.

Conclusions

The lack of standardized criteria for rehabilitation assessment of post-stroke dysphagia has resulted in reported recovery rates of swallowing function exhibiting wide variability. Nurses should take targeted preventive measures for patients aged ≥70 years, low BMI, bilateral stroke, high NIHSS score, tracheal intubation, and aspiration to promote the recovery of swallowing function in patients with post-stroke dysphagia.