Frontiers in neurology · 2026
Swallowing trajectories and influencing factors among subacute stroke patients with dysphagia in rehabilitation wards: a longitudinal study.
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Zhu Yanan, Tang Xiuru, Guo Meng, Li Min, Sun Shiyan, Zhou Minmin, Yu Xiurong
Аннотация
BACKGROUND: Rehabilitation training is crucial for subacute stroke patients with dysphagia. However, research on trajectories of clinical swallowing performance and associated influencing factors following admission to rehabilitation wards remains quite limited. This study aimed to identify these trajectories and influencing factors among this specific patient population.
METHODS: A total of 143 subacute stroke patients with dysphagia were recruited from the rehabilitation ward between April 2024 and July 2025 by convenience sampling. All patients completed baseline assessments within 24 h of admission using the Standardized Swallowing Assessment (SSA), Oral Health Assessment Tool (OHAT), Nutritional Risk Screening 2002 (NRS 2002), Fatigue Severity Scale (FSS), and Patient Health Questionnaire-9 (PHQ-9). Clinical swallowing performance was then reassessed using the SSA at 7, 14, 21, and 28 days after admission. Latent class growth modeling (LCGM) based on repeated SSA scores over the 4-week follow-up was used to identify distinct clinical swallowing performance trajectories, and multinomial logistic regression was used to analyze their influencing factors.
RESULTS: Based on the longitudinal SSA data, the clinical swallowing performance trajectories of subacute stroke patients with dysphagia in inpatient rehabilitation were classified into three groups: a mild-rapid improvement group (31%), a moderate-steady improvement group (41%), and a severe-slow improvement group (28%). Age, oral health status, depression, and fatigue were significantly associated with trajectory membership.
CONCLUSION: Subacute inpatients with post-stroke dysphagia exhibit three distinct clinical swallowing performance trajectories, demonstrating significant group heterogeneity. These trajectories may assist in early risk stratification and individualized care planning.
METHODS: A total of 143 subacute stroke patients with dysphagia were recruited from the rehabilitation ward between April 2024 and July 2025 by convenience sampling. All patients completed baseline assessments within 24 h of admission using the Standardized Swallowing Assessment (SSA), Oral Health Assessment Tool (OHAT), Nutritional Risk Screening 2002 (NRS 2002), Fatigue Severity Scale (FSS), and Patient Health Questionnaire-9 (PHQ-9). Clinical swallowing performance was then reassessed using the SSA at 7, 14, 21, and 28 days after admission. Latent class growth modeling (LCGM) based on repeated SSA scores over the 4-week follow-up was used to identify distinct clinical swallowing performance trajectories, and multinomial logistic regression was used to analyze their influencing factors.
RESULTS: Based on the longitudinal SSA data, the clinical swallowing performance trajectories of subacute stroke patients with dysphagia in inpatient rehabilitation were classified into three groups: a mild-rapid improvement group (31%), a moderate-steady improvement group (41%), and a severe-slow improvement group (28%). Age, oral health status, depression, and fatigue were significantly associated with trajectory membership.
CONCLUSION: Subacute inpatients with post-stroke dysphagia exhibit three distinct clinical swallowing performance trajectories, demonstrating significant group heterogeneity. These trajectories may assist in early risk stratification and individualized care planning.