To investigate the association between dysphagia and stroke-associated pneumonia (SAP) after stroke in the elderly.

A prospective study was conducted on 161 elderly stroke patients admitted to the First Neurology Department of Handan Central Hospital from March 2020 to January 2021. They were divided into two groups based on the results of water swallow test after 24 h of admission, with 49 patients without dysphagia as the non-dysphagia group and 112 patients with dysphagia as the dysphagia group. According to the severity of dysphagia, the dysphagia group were divided into three subgroups, with 43 cases in the mild group, 38 cases in the moderate group, and 31 cases in the severe group. The incidence, occurrence time and prognosis of SAP were compared among three subgroups. Pearson analysis was used to analyze the correlation between the degree of dysphagia and the occurrence and occurrence time of SAP. Logistic regression was used to analyze the influence of dysphagia on the occurrence of SAP.

There were no significant differences in pseudobulbar palsy, diabetes, history of pulmonary disease and stroke site composition between the dysphagia group and the non-dysphagia group (P>0.05). There were significant differences in incidence, occurrence time, APACHE Ⅱ score, mean treatment time, number of affected lung lobes and mortality of SAP among severe, moderate, mild and non-dysphagia groups (all P<0.05). The degree of dysphagia was negatively correlated with the occurrence time of SAP (r=-0.407, P=0.038), it was positively correlated with SAP occurrence (r=0.328, P=0.043). Logistic regression analysis showed that dysphagia was a risk factor for SAP (OR=2.719, 95%CI: 1.152-7.483, P<0.05).

Dysphagia is a high risk factor for the occurrence of SAP in stroke patients, and the severity of dysphagia is positively correlated with the incidence of SAP, and negatively correlated with the occurrence time of SAP. SAP will significantly affect the prognosis of patients. It is suggested that attention should be paid to the prevention and treatment of dysphagia in stroke patients to reduce the incidence of SAP.