Analysis of Risk Factors Associated With Aspiration in Patients With Poststroke Dysphagia: A Real‐World Study
Bibliographic record
Abstract
BACKGROUND: Aspiration is the most severe complication of dysphagia in patients with poststroke dysphagia (PSD). However, the risk factors associated with aspiration remain inadequately understood. OBJECTIVE: To determine the associated risk factors for aspiration in patients with PSD. METHODS: A total of 321 dysphagia patients with first-ever stroke were retrospectively enrolled. We differentiated patients with aspiration from those without aspiration via swallowing function screening, clinical swallowing function examinations, and videofluoroscopic swallowing studies. We conducted a comparative analysis of the basic demographic data, disease-related information, and clinical characteristics between the two groups via multivariate logistic regression. RESULTS: Multivariate logistic regression analysis revealed that age ≥ 65 years (OR = 3.596, 95% CI: 1.251-10.335), history of pneumonia (OR = 3.617, 95% CI: 1.174-11.148), severe dysarthria (OR = 7.331, 95% CI: 1.314-40.889), number of chronic diseases > 2 (OR = 4.814, 95% CI: 1.61-14.397), bilateral brain injury (OR = 6.673, 95% CI: 1.926-23.115), a lesion location in the brainstem (OR = 4.581, 95% CI: 1.05-19.987), and a higher water swallowing test score (OR = 1.806, 95% CI: 1.113-2.93) were risk factors for aspiration. Conversely, a high Montreal Cognitive Assessment (MoCA) score (OR = 0.919, 95% CI: 0.849-0.995) and a high cut-off value of the repetitive saliva swallowing test (RSST) (OR = 0.149, 95% CI: 0.067-0.332) were identified as protective factors. DISCUSSION: Timely diagnosis and intervention for aspiration should prioritise patient populations aged 65 years and older, individuals with a history of pneumonia, those exhibiting severe dysarthria, patients with multiple chronic conditions, individuals with bilateral brain injuries, patients with lesions situated in the brainstem, and those exhibiting higher WST scores. TRIAL REGISTRATION: This study was registered with the Chinese Clinical Trial Registry (registration number: ChiCTR2500097142).
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 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, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
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".