| Objective: This study aims to investigate the factors influencing aspiration in stroke patients with dysphagia when consuming foods of varying consistencies using video fluoroscopic swallowing study (VFSS). The findings are intended to provide clinical guidance for the prevention and treatment of aspiration in post-stroke patients.Methods: A retrospective analysis was performed on VFSS recordings from 123 stroke patients with dysphagia while consuming three different consistencies of foods: thin liquids, thick liquids, and puree. Aspiration served as the dependent variable, while independent variables included age, gender, clinical diagnosis, lesion location (brainstem vs. non-brainstem), delayed swallow initiation, oral propulsion difficulties, epiglottic residue, pyriform sinus residue, and cricopharyngeal dysfunction. Univariate analysis was conducted, followed by multivariate logistic regression for variables showing statistical significance. Results: Logistic regression analysis revealed that for thin liquids, brainstem lesions and delayed swallow initiation were significantly associated with aspiration risk (OR=4.618, OR=2.323, both P<0.05). For thick liquids, oral propulsion difficulties were identified as an independent risk factor (OR=3.840, P<0.05). In patients consuming puree, both brainstem lesions and oral propulsion difficulties were significantly associated with aspiration (OR=2.683, OR=3.463, both P<0.05).Conclusion: Stroke patients with brainstem lesions, delayed swallow initiation, or oral propulsion difficulties are at higher risk of aspiration when consuming thin liquids and puree. Additionally, patients with oral propulsion difficulties and non-brainstem lesions are more likely to aspirate when consuming thick liquids. |
