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Abstract
Objective: To determine the frequency of dysphagia among patients presenting with acute stroke, and to identify the demographic and clinical factors associated with it, at a tertiary care hospital in Bannu, Pakistan.
Study Design: Cross-sectional study.
Place and Duration of Study: Department of General Medicine, Khalifa Gul Nawaz Teaching Hospital, MTI, Bannu.
Duration of study:2nd February 2025 to 2nd April 2025.
Methodology: One hundred and forty-four patients aged 30–70 years with a first presentation of acute stroke, confirmed clinically and by computed tomography, were enrolled through consecutive non-probability sampling. Dysphagia was assessed at the bedside with a graded water-swallow test (3, 5, 10, 20, and 50 mL), adapted from the Gugging Swallowing Screen; a positive result was cough during swallowing or a fall in pulse-oximetry saturation of ≥2% from baseline. Demographic and clinical data were recorded on a structured proforma. Dysphagia was stratified against age, gender, body mass index, stroke duration, smoking, hypertension, diabetes, residence, profession, education, and socioeconomic background using the chi-square test, with Fisher's exact test applied where expected cell counts were below 5. A p-value ≤0.05 was taken as significant. Data were analyzed using IBM SPSS version 21.
Results: Dysphagia was present in 56 of 144 patients (38.9%). Patients with dysphagia were significantly older than those without (58.6±9.0 vs 51.8±10.0 years, p<0.001), and its frequency rose from 7.7% in patients aged 30–40 years to 60.4% in those aged 61–70 years (p=0.0003). Dysphagia was also more frequent among current smokers (57.1% vs 34.5%, p=0.046) and varied significantly by occupation, being highest among retired patients (60.7%, p=0.041). Gender, body mass index, stroke duration, hypertension, diabetes, residence, education, and socioeconomic background showed no statistically significant association with dysphagia.
Conclusion: Dysphagia affected almost two in five patients with acute stroke in this cohort, a figure consistent with regional and international literature, and was most strongly associated with advancing age. Routine, early bedside swallow screening is warranted in acute stroke patients, particularly those over 60 years, to reduce the risk of aspiration and its complications.