Effects of oral hygiene care on swallowing recovery in hospitalised patients with post-stroke dysphagia: a systematic review and meta-analysis.

IF 5.2 3区医学 Q1 CLINICAL NEUROLOGY

European Stroke Journal Pub Date : 2026-10-05 DOI:10.1093/esj/aakag126

Sungkrit Pojmonpiti, Mariska Meersschaut, Katja Batens, Margot Baudelet, Veerle De Herdt, Barbara Janssens

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引用次数: 0

Abstract

Objective: To evaluate the effects of oral hygiene care on swallowing-related outcomes in hospitalised patients with post-stroke dysphagia (PSD).

Methods: A systematic literature search was conducted in MEDLINE, Embase, Web of Science, Scopus, CINAHL, CENTRAL and ClinicalTrials.gov up to May 2026. Randomised controlled trials (RCTs) and non-RCTs with a comparison group that reporting swallowing-related outcomes were included. Risk of bias was assessed using RoB 2 for RCTs and ROBINS-I for non-RCTs. Where appropriate, meta-analyses were conducted using random-effects models to estimate mean differences (MDs), odds ratios (ORs) and risk differences (RDs) with 95% confidence intervals (CIs). The certainty of the evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework.

Results: Nine studies, comprising 7 RCTs and two non-RCTs, were included, with risk-of-bias ratings ranging from low risk to some concerns for RCTs and moderate risk for non-RCTs. Oral hygiene care increased the odds of achieving independent oral intake compared with usual care (OR = 2.54, 95% CI, 1.80; 3.59; I2 = 0%), corresponding to a 13% absolute increase (RD = 0.13, 95% CI, 0.03; 0.23; I2 = 0%). Functional Oral Intake Scale (FOIS; scores 1-7), with higher scores indicating more independent and unrestricted oral intake, favoured oral hygiene care (MD = 0.40, 95% CI, 0.07; 0.72; I2 = 0%). Similarly, Gugging Swallowing Screen (GUSS; scores 0-20), assessing swallowing safety and dysphagia severity, favoured oral hygiene care (MD = 2.93, 95% CI, 1.01; 4.85; I2 = 0%). The certainty of the evidence for achieving independent oral intake was rated as high.

Conclusion: Oral hygiene care supports swallowing recovery in patients with PSD, particularly independent oral intake and should be considered an active component of dysphagia rehabilitation.

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口腔卫生护理对卒中后吞咽困难住院患者吞咽恢复的影响：系统回顾和荟萃分析。

目的：探讨口腔卫生护理对脑卒中后吞咽困难（PSD）住院患者吞咽相关结局的影响。方法：系统检索截至2026年5月的MEDLINE、Embase、Web of Science、Scopus、CINAHL、CENTRAL和ClinicalTrials.gov等数据库的文献。随机对照试验（rct）和非rct与报告吞咽相关结果的对照组被纳入。随机对照试验采用rob2，非随机对照试验采用robins - 1评估偏倚风险。在适当的情况下，使用随机效应模型进行meta分析，以95%置信区间（ci）估计平均差异（MDs）、优势比（ORs）和风险差异（RDs）。使用建议评估、发展和评价分级（GRADE）框架评估证据的确定性。结果：纳入了9项研究，包括7项随机对照试验和2项非随机对照试验，随机对照试验的偏倚风险评级从低风险到部分关注，非随机对照试验的偏倚风险评级为中等风险。与常规护理相比，口腔卫生护理增加了实现独立口服摄入的几率（OR = 2.54, 95% CI, 1.80; 3.59; I2 = 0%），对应于13%的绝对增加（RD = 0.13, 95% CI, 0.03; 0.23; I2 = 0%）。功能性口服摄入量表（FOIS；得分1-7分），得分越高表明口腔摄入越独立和不受限制，越倾向于口腔卫生保健（MD = 0.40, 95% CI, 0.07; 0.72; I2 = 0%）。类似地，用于评估吞咽安全性和吞咽困难严重程度的gugging吞咽筛查（GUSS，评分0-20分）更倾向于口腔卫生护理（MD = 2.93, 95% CI, 1.01; 4.85; I2 = 0%）。实现独立口服摄入的证据的确定性被评为高。结论：口腔卫生护理有助于PSD患者的吞咽康复，特别是独立的口服摄入，应被视为吞咽困难康复的一个积极组成部分。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Stroke Journal Multiple-

CiteScore

7.50

自引率

6.60%

发文量

102

期刊介绍： Launched in 2016 the European Stroke Journal (ESJ) is the official journal of the European Stroke Organisation (ESO), a professional non-profit organization with over 1,400 individual members, and affiliations to numerous related national and international societies. ESJ covers clinical stroke research from all fields, including clinical trials, epidemiology, primary and secondary prevention, diagnosis, acute and post-acute management, guidelines, translation of experimental findings into clinical practice, rehabilitation, organisation of stroke care, and societal impact. It is open to authors from all relevant medical and health professions. Article types include review articles, original research, protocols, guidelines, editorials and letters to the Editor. Through ESJ, authors and researchers have gained a new platform for the rapid and professional publication of peer reviewed scientific material of the highest standards; publication in ESJ is highly competitive. The journal and its editorial team has developed excellent cooperation with sister organisations such as the World Stroke Organisation and the International Journal of Stroke, and the American Heart Organization/American Stroke Association and the journal Stroke. ESJ is fully peer-reviewed and is a member of the Committee on Publication Ethics (COPE). Issues are published 4 times a year (March, June, September and December) and articles are published OnlineFirst prior to issue publication.