Analysis of the current situation and influencing factors of implicit aspiration in patients with severe stroke and the construction of clustered intervention model
Analysis of the current situation and influencing factors of implicit aspiration in patients with severe stroke and the construction of clustered intervention model
Objective To analyze the status quo and influencing factors of recessive aspiration in severe stroke patients and build a risk assessment model to guide the early clinical identification of recessive aspiration high-risk group.Methods Sixty patients with severe stroke admitted to the People's Hospital of Bozhou from January 2021 to June 2022 were selected,and were divided into aspiration group(28 cases)and non-aspiration group(32 cases)according to the incidence of aspiration.The clinical data of the two groups were compared,the influencing factors for recessive aspiration were determined by Logistic regression analysis,and the risk assessment model was built based on the results of influencing factors.Results Latent aspiration occurred in 28(46.67％)of 60 patients with severe stroke.The proportion of age＞70 years old in aspiration group,GCS score＜9 points,cough reflex weakened or disappeared,swallowing dysfunction,gastrointestinal motility disorder and feeding through nasal feeding tube in aspiration group were higher than those in non-aspiration group(P＜0.05).Multivariate Logistic regression analysis showed that age(OR=2.192,95％CI:1.157-4.154),disturbance of consciousness(OR=2.787,95％CI:1.412-5.502),swallowing dysfunction(OR=3.365,95％CI:1.412-8.019)and gastrointestinal motility disorders(OR=2.502,95％CI:1.131-5.533)were the influential factors for recessive aspiration in patients with severe stroke(P＜0.05).Based on the results,a risk assessment model was constructed.The total score of the model was 0 to 5,and the total score of 0 to 1 was classified as low risk,2 to 3 as medium risk,and 4 to 5 as high risk.The incidence of recessive aspiration in low-risk,medium-risk and high-risk patients was 6.25％,42.31％and 88.89％,respectively,the incidence of recessive aspiration in middle-risk patients was higher than that in low-risk patients,the high-risk patients were higher than medium-risk and low-risk patients(P＜0.05).Conclusion The occurrence of occult aspiration in patients with severe stroke is mainly affected by age,consciousness disorder,swallowing dysfunction and gastrointestinal motivity disorder.The construction of risk assessment model based on multivariate Logistic regression analysis can help identify high-risk patients with aspiration in early clinical stage,and is conducive to the implementation of targeted intervention and prevention of aspiration.
关键词
重症脑卒中/隐性误吸/影响因素/危险评估模型/神经康复
Key words
Severe stroke/Implicit aspiration/Influencing factors/Risk assessment model/Neurorehabilitation
维普
万方数据