International Journal of Clinical Research

Objective To identify the core influencing factors of aspiration risk in stroke patients with dysphagia based on real-world clinical scenarios, analyze the correlation between clinical assessment indicators and real-world prognosis, construct targeted prevention and control strategies, and verify their application effects. Methods A retrospective cohort study was conducted on 4000 stroke patients admitted to the Department of Neurology of a tertiary-level hospital from October 2022 to October 2025. Baseline data, swallowing function assessment (GUSS scale), and prognostic data were collected. Univariate and multivariate logistic regression analyses were used to analyze independent risk factors for aspiration and to verify the effectiveness of the prevention and control strategies. Results The incidence of dysphagia in stroke patients was 37.50%, with an aspiration pneumonia rate of 12.00%, significantly higher than the 1.00% in the group without dysphagia (P < 0.001). Acute pneumonia accounted for 75.00%, with silent aspiration being the main contributing factor, accounting for 75% and 40% in the two groups, respectively. Age ≥ 70 years, brainstem stroke, GUSS score ≤ 8, and cognitive impairment were independent risk factors for aspiration (P < 0.05). Conclusion The risk of aspiration in stroke patients with dysphagia is influenced by multiple factors, with acute aspiration and silent aspiration being key to prevention and control. Individualized prevention and control programs based on risk factors can effectively reduce the incidence of aspiration and improve the quality of nursing care.

Stroke; Dysphagia; Aspiration risk; Clinical assessment; Prognostic association