Predictive Factors for Post-Stroke Dysphagia in Patients after endovascular thrombectomy for Anterior Circulation Large Vessel Occlusion: A Retrospective Cohort Study

Abstract

Purpose To identify the predictive variables for post-stroke dysphagia (PSD) among anterior circulation large vessel occlusion (LVO) stroke patients who underwent endovascular thrombectomy (EVT). Methods This retrospective cohort study enrolled hospitalized patients with anterior LVO stroke who underwent EVT between January 1, 2018 and October 31, 2022. PSD was defined as the unsuccessful removal of the nasogastric (NG) tube. Factors such as premorbid characteristics, laboratory results, EVT, rehabilitation-related parameters, and neuro-imaging were analyzed for correlations to PSD at 4 and 12 weeks. Results The study enrolled 136 patients and found that lower albumin, lower body mass index (BMI), higher initial and 24-hour post-EVT National Institute of Health Stroke Scale (NIHSS) scores, stroke-associated pneumonia, poor initial sitting balance and ability to sit up, insula or frontal operculum lesions, and bilateral hemisphere involvement were all associated with PSD at both 4 and 12 weeks in the univariate logistic regression. Moreover, the multivariate analysis revealed that lower BMI, insular lesions, and bilateral hemisphere involvement were significant predictors of PSD at both time points. Conclusions In patients with anterior LVO following EVT, PSD was associated with lower BMI, higher NIHSS scores, poor initial sitting balance and sitting ability, insular lesions, and bilateral hemisphere involvement.