Predictors of recovery from dysphagia after stroke: A systematic review and meta-analysis
Bibliographic record
Abstract
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. 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). 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. 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.
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How this classification was reachedexpand
Direct model labels (unvalidated)
Per-model category and study-design labels from the labeling rounds. They are machine output, unvalidated, and the disagreement between models ships as data. No study design here is MEDLINE-validated yet.
| Model arm | Categories | Study design | Confidence |
|---|---|---|---|
| gemma | no category Domain: not available · Genre: Review About the Canadian research system: no · About a Canadian topic: no | Meta-analysis | low |
| gpt | no category Domain: not available · Genre: Review About the Canadian research system: no · About a Canadian topic: no | Meta-analysis | high |
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.004 | 0.002 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedLabeled directly by 2 models reading the full record.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".