| 제목 |
Status of Post-stroke Dysaphgia in South Korea |
| 소속 |
Konkuk University Medical Center, Department of Rehabilitation Medicine1, Konkuk University School of Medicine, 3Research Institute of Medical Science2, Chungnam National University School of Medicine, Department of Rehabilitation Medicine3, Yonsei University College of Medicine, Department and Research Institute of Rehabilitation Medicine4, Chonnam National University Medical School, Department of Physical and Rehabilitation Medicine5, Pusan National University School of Medicine, Pusan National University Yangsan Hospital, Department of Rehabilitation Medicine6, Wonkwang University, School of Medicine, Department of Preventive Medicine7, Kyungpook National University School of Medicine, Kyungpook National University Hospital, Department of Rehabilitation Medicine8, Wonkwang University School of Medicine, Department of Rehabilitation Medicine9, Jeju National University Hospital, Jeju National University School of Medicine, Department of Rehabilitation Medicine10, Hallym University, Department of Statistics and Institute of Statistics11, Ewha Womans University, Department of Health Convergence12, Korea Centers for Disease Control and Prevention, Division of Chronic Disease Prevention, Center for Disease13, Korea Centers for Disease Control and Prevention, Division of Chronic Disease Prevention, Center for Disease14, Samsung Medical Center, Sungkyunkwan University School of Medicine, Department of Physical and Rehabilitation Medicine, Heart Vascular Stroke Institute15, Sungkyunkwan University, Department of Health Science and Technology, Department of Medical Device Management and Research, Department of Digital Health, SAIHST16 |
| 저자 |
Nayeon Ko1*, Hyun Haeng Lee1, Jongmin Lee1,2†, Min Kyun Sohn3, Deog Yung Kim4, Sam-Gyu Lee5, Yong-il Shin6, Gyung-Jae Oh7, Yang-Soo Lee8, Min Cheol Joo9, So Young Lee10, Junhee Han11, Jeonghoon Ahn12, Ji Yoo Choi13, Sung Hyun Kang13, Young Taek Kim13,14, Won Hyuk Chang15, Yun-Hee Kim15,16† |
Objective
Poststroke dysphagia is a common symptom in stroke patients There are few reports covering the incidence of poststroke dysphagia in South Korea. This study aimed to describe the current status of poststroke dysphagia incidence and recovery in South Korea. We also demonstrated the clinical factors affecting recovery of poststroke dysphagia by comparing the subgroup which had showed the distinct recovery pattern of poststroke dysphagia after discharge from acute care hospital.
Method
We screened the patients enrolled for Korean Stroke Cohort for functioning and rehabilitation (KOSCO), which was a prospective multi-center cohort of stroke patients admitted to university hospitals in nine distinct areas of Korea (KOSCO). We included the patients with first ever acute stroke, with onset of symptoms within seven days prior to screening, and with age more than 19-year-old were included in this study. We excluded patients who had previous history of stroke, transient ischemic attack, traumatic intracranial hemorrhage, non-Korean nationality, and any missing values of follow-up ASHA-NOMS grade. We also dichotomized the patients who had been fed only through tube (nasogastric tube or percutaneous endoscopic gastrostomy tube) at discharge from acute hospital, according to the feeding status at pos-stroke 12 months (Group A; tube feeding, Group B; general diet) to identify the clinical factors affecting poststroke dysphagia recovery.
Result
The proportion of poststroke dysphagia patients during 2-year follow up period are described in Table 1. Nearly 9% of patients had severe dysphagia with tube feeding at the time of discharge and they were discharged from acute hospital at 34.43 ± 41.80 days after stroke.
There were significant differences of age at stroke onset (Group A vs. Group B; 72.45 ± 11.78 vs 62.23 ± 12.26 , P<0.001), BMI (Group A vs. Group B; 22.23 ± 3.17 vs 23.56 ± 4.29, P<0.05), and initial NIHSS (Group A vs Group B; 22.16 ± 8.17 vs 12.81 ± 10.15, P<0.001) between two subgroups. Furthermore, Mini-Mental State Examination (MMSE) and the Fugl-Meyer Assessment (FMA) score were significantly higher in Group B than Group A, entirely during the poststroke 12 months period.
Conclusion
We demonstrated the incidence and recovery pattern of poststroke dysphagia in South Korea. We also showed the patients who had shown the full recovery of poststroke dysphagia at poststroke 12 months from tube-fed status at discharge from acute hospital had younger age of stroke onset, higher BMI, lower initial NIHSS, higher FMA and higher MMSE compared to the patients who remained tube-fed at poststroke 12 months.
|
|
Table 1. Proportion of stroke patients according to the severity of dysphagia
Table 2. Comparison between two groups; Group A with patients whose feeding status at discharge was tube feeding and still maintaining tube feeding at poststroke 12 months, and Group B with patients whose feeding status at discharge was tube feeding but having general diet at poststroke 12 months.
|
