Up to 80% of stroke patients suffer from dysphagia. It is associated with increased morbidity, mortality, and healthcare costs due to aspiration, pneumonia, and malnutrition, which represent a significant burden to stroke survivors, their relatives, and the healthcare system. Early recognition and management of post-stroke dysphagia is key to reducing its complications and enhancing patients' quality of life. Despite the importance of dysphagia following a stroke and its adverse consequences, no study has investigated dysphagia after stroke in Oman. This study was conducted to estimate the prevalence of post-stroke dysphagia and its severity among acute stroke patients, assess the association between the selected factors and dysphagia, and identify dysphagia predictors.

A cross-sectional descriptive study design was utilized to identify the prevalence and risk factors for post-stroke dysphagia among acute stroke patients (n = 274) admitted to two Omani tertiary hospitals over 6 months. Dysphagia was assessed using the Gugging swallowing screen. Descriptive analysis, correlations, and regression analysis were computed.

The prevalence of dysphagia following stroke was 70.1%. Among those who had dysphagia, 37.5% had severe, 31.25% moderate, and 31.25% mild dysphagia. Aging, obesity, having a medical co-morbidity, hypertension, stroke location, low Glasgow Coma Scale (GCS) score, and the use of thrombectomy or thrombolysis therapy were contributing factors and were found to be correlated with post-stroke dysphagia. This study revealed that old age [odds ratio (OR) = 0.961, 95% confidence interval (CI): 0.933-0.989, P = 0.007)], obesity (OR = 0.387, 95% CI: 0.157-0.952, P = 0.039), and low GCS score (OR = 0.027, 95% CI: 0.009-0.077, p=<0.001) were predictors of dysphagia after stroke.

Post-stroke dysphagia is more common among acute stroke patients. There are various risk factors correlated with dysphagia following a stroke. Therefore, dysphagia predictors should be considered when designing dysphagia prevention strategies to reduce its adverse consequences. Recognition of such predictors may help with the early detection and treatment of dysphagic patients and the implementation of preventive approaches.

Stroke frequently results in oropharyngeal dysfunction (OD), leading to difficulties in swallowing and eating, as well as triggering negative emotions, malnutrition, and aspiration pneumonia, which can be detrimental to patients. However, routine nursing interventions often fail to address these issues adequately. Systemic and psychological interventions can improve dysphagia symptoms, relieve negative emotions, and improve quality of life. However, there are few clinical reports of systemic interventions combined with psychological interventions for stroke patients with OD.

To explore the effects of combining systemic and psychological interventions in stroke patients with OD.

This retrospective study included 90 stroke patients with OD, admitted to the Second Affiliated Hospital of Qiqihar Medical College (January 2022-December 2023), who were divided into two groups: regular and coalition. Swallowing function grading (using a water swallow test), swallowing function [using the standardized swallowing assessment (SSA)], negative emotions [using the self-rating anxiety scale (SAS) and self-rating depression scale (SDS)], and quality of life (SWAL-QOL) were compared between groups before and after the intervention; aspiration pneumonia incidence was recorded.

Post-intervention, the coalition group had a greater number of patients with grade 1 swallowing function compared to the regular group, while the number of patients with grade 5 swallowing function was lower than that in the regular group (P < 0.05). Post-intervention, the SSA, SAS, and SDS scores of both groups decreased, with a more significant decrease observed in the coalition group (P < 0.05). Additionally, the total SWAL-QOL score in both groups increased, with a more significant increase observed in the coalition group (P < 0.05). During the intervention period, the total incidence of aspiration and aspiration pneumonia in the coalition group was lower than that in the control group (4.44% vs 20.00%; P < 0.05).

Systemic intervention combined with psychological intervention can improve dysphagia symptoms, alleviate negative emotions, enhance quality of life, and reduce the incidence of aspiration pneumonia in patients with OD.

Background: Post-stroke dysphagia (PSD) affects the quality of life in stroke patients, impairs their rehabilitation ability, and causes other complications following stroke. Currently, there is currently some understanding of PSD risk factors, but its protective factors remain largely unknown. Objective: To analyze the effects of acupuncture (AP) on dysphagia in stroke patients and explore its potential as a preventive therapy. Methods: Patients with a diagnosis of stroke from 2010 to 2019 were selected and followed until 2020, utilizing factors such as age, gender, stroke location, stroke type, and baseline comorbidity. To compare the incidence of dysphagia, equal numbers of stroke patients treated with and without AP (n = 1,809) were matched by 1:1 propensity scoring. The Cox proportional hazards model and Kaplan-Meier method were used to assess the risk of dysphagia as an outcome measure. Results: The stroke patients treated with AP had a lower risk of dysphagia after adjusting for age, gender, stroke location, stroke type, and baseline comorbidity [adjusted hazard ratio (AHR) = 0.43, 95% confidence interval = 0.37-0.49] compared with those in the non-AP cohort. AP also decreased the risk of PSD among different gender groups. The risk ratios were AHR = 0.45 and AHR = 0.33 for males and females, respectively. AP also reduced the risk for PSD among different age groups. The risk ratios were AHR = 0.20, AHR = 0.37, AHR = 0.41, and AHR = 0.45 for the 18-39, 40-59, 60-79, and >80 years-old groups. Regarding stroke types (ischemic, hemorrhagic, and mixed type), patients treated with AP had a lower risk (AHR = 0.47, 0.28 and 0.17, respectively). With respect to stroke location, the risk of PSD in AP-treated patients was decreased regardless of location: brain stem (AHR = 0.41), diencephalon (AHR = 0.13), or multiple lesions (AHR = 0.40), the risk of PSD in AP-treated patients was decreased. For all baseline comorbidities, AP attenuated the risk of dysphagia. The cumulative incidence of dysphagia was remarkably lower in the AP group than in the non-AP group (log-rank test, P = 0.000). Limitations: First, this was a single-center clinical retrospective study. Second, we did not classify the severity of stroke and dysphagia. Third, all data were extracted manually. Lastly, the sample size was relatively small. Thus, future studies with larger sample sizes are warranted to verify our findings. Conclusion: Acupuncture treatment attenuates the risk of dysphagia in stroke patients. Future research should increase the sample size and elaborate further on the details of the AP protocol.