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A simple nomogram for predicting aspiration associated with dysphagia in hospitalized patients after stroke

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Abstract

Background

Aspiration is a common complication of poststroke dysphagia (PSD) and is associated with poor prognosis and mortality. There is no uniform criterion for determining aspiration associated with dysphagia. The aim of this study was to identify early predictors of aspiration, leading to the development of a simple nomogram for identifying aspiration risk associated with dysphagia in hospitalized patients after stroke.

Methods

Demographic information and clinical characteristics of 330 patients with PSD in the training cohort were utilized to develop a nomogram. The LASSO regression method was used to screen variables, and logistic regression was used to construct the nomogram. Internal validation was performed with bootstrap in the training cohort, and external validation was performed in the validation cohort of another 82 patients. The area under the curve (AUC), calibration curves, and decision curve analysis (DCA) were used to evaluate the performance of the nomogram.

Results

Seven variables were selected based on LASSO and multivariate logistic regression. The AUC of the nomogram was 0.834 (95% CI, 0.790–0.878) in the training cohort, 0.806 (95% CI, 0.791–0.880) in the internal validation cohort, and 0.882 (95% CI, 0.810–0.954) in the external validation cohort, which indicated that the model had good discrimination. The calibration and DCA curves showed that the nomogram had good accuracy and clinical utility.

Conclusions

In this study, we established a nomogram that can be used to identify the risk of aspiration associated with dysphagia after stroke, and patients may benefit from early screening and preventive care.

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Data availability

The data that support the findings of this study are available from the corresponding author, upon reasonable request.

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Acknowledgements

The authors would like to thank the study participants and clinical staff for their support and contributions to this study.

Funding

This work was supported by funding from the National Natural Science Foundation of China (Program No. 72364005).

Author information

Authors and Affiliations

  1. Department of Nursing, Guizhou Provincial People’s Hospital, 83 East Zhongshan Road, Guiyang City, Guizhou, China

    Lihua Chen, Juan Li & Zuoxiu Chen

  2. School of Nursing, Guizhou University of Traditional Chinese Medicine, Guiyang, Guizhou, China

    Lihua Chen, Chao Xue & Juan Xue

  3. Department of Neurology, Guizhou Provincial People’s Hospital, Guiyang, Guizhou, China

    Fang Tian

  4. School of Nursing, Zunyi Medical University, Zunyi, Guizhou, China

    Huan Tang

  5. Department of Endoscopy, Guizhou Provincial People’s Hospital, Guiyang, Guizhou, China

    Mingqing Hao

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  1. Lihua Chen
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Contributions

Lihua Chen and Juan Li carried out the conception and design of the research.

Lihua Chen and Fang Tian participated in the acquisition of data.

Huan Tang and Juan Xue participated in data curation.

Zuoxiu Chen, Mingqing Hao, and Chao Xue performed the statistical analysis.

Juan Li participated in obtaining funding.

Lihua Chen and Juan Li drafted the manuscript and participated in revision of the manuscript for important intellectual content.

All authors read and approved the final manuscript.

Corresponding author

Correspondence to Juan Li.

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Ethical approval

The study received ethical approval from the Guizhou Provincial People’s Hospital Ethics Committee under the reference number “Ethical Approval Word (Research) [2022] No. 130.”

Informed consent

All patients or their consultees signed a written informed consent for participation and publication.

Conflict of interest

The authors declare no competing interests.

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Chen, L., Li, J., Tian, F. et al. A simple nomogram for predicting aspiration associated with dysphagia in hospitalized patients after stroke. Neurol Sci 45, 2729–2736 (2024). https://doi.org/10.1007/s10072-024-07312-2

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  • DOI: https://doi.org/10.1007/s10072-024-07312-2

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