Continuity of Care Improves Swallowing Function and Reduces Respiratory Complications After Stroke In China: A Systematic Review and Meta-Analysis
Xinglei Wang, Yingqiao Wang, Weiping Li3, Juanping Zhong, Peifen Ma,Yinping Wu, Xinman Dou
Abstract
Objective To determine the effectiveness of continuous care compared to standard care on Chinese patients with Post-stroke dysphagia. Methods Cochrane Library, EMBASE, PUBMED, and Web of Science were searched for China studies published in English; the China Biology Medicine (CBM), China Science and Technology Journal Database (VIP), China National Knowledge Infrastructure (CNKI), and Wan fang Database were searched for studies published in Chinese up to January 2023. Data and information were extracted by two reviewers independently and disagreement was resolved by consensus with a third coauthor. Primary outcome was represented by swallowing function, secondary outcomes would be the occurrence of respiratory complications and the quality of life was the third outcomes. The quality of each study included RCT was assessed by the Cochrane risk-of-bias criteria. The GRADE evidence profile was provided to present information about the body of evidence and judgments about the certainty of underlying evidence for each outcome. Meta-analysis of data was performed using RevMan5.3 analysis software.
Results11 RCT studies and 979 patients were finally included.The heterogeneity of the included studies was not significant (I2=37%, P=0.11) and fixed-effects model yielded was used for combined analysis. Continuity of care improves swallowing function [RR=1.43, 95%CI (1.32, 1.54), P<0.001] and reduces respiratory complications [RR=0.18.95%CI (0.09, 0.38), P<0.001] . Continuity of care can also improves the quality of life [MD=20.23, 95%CI (16.06, 24.39), P<0.001]
Conclusion This meta-analysis provided evidence that continuity of care is effective to improve swallowing function, quality of life, and reduces the risk of respiratory complications. Due to the poor quality of the included literature, additional multicenter studies using larger patient cohorts are required to validate and support these findings. Furthermore, long-term follow-up studies should be performed to measure outcomes, while avoiding bias due to confounding factors such as heterogeneity of the evaluation of dysphagia.
Full Text: PDF DOI: 10.15640/ijhs.v11n1a7
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