Background And Aims: Dysphagia is significantly correlated with prognostic outcomes in patients with stroke; however, the intrinsic mechanism of action between the two remains unclear. This study aimed to model the intrinsic mechanism of action between dysphagia and prognostic outcomes in patients with stroke based on structural equation modeling.
Methods: A retrospective analysis of 900 inpatients with stroke from three large hospitals was performed. AMOS software (version 23.0) was used to construct the structural equation modeling.
Results: The overall model showed a good fit (chi-square = 27.3, root mean square error of approximation = 0.01, standardized root mean square residual = 0.032, comparative fit index = 0.98, and adjusted goodness of fit = 0.94). Structural equation modeling showed that the total effect of dysphagia on the prognosis of patients with stroke was 0.694, with a direct effect of 0.599, accounting for 86.31 % of the total effect. The total indirect effect was 0.095, with the mediating effects of serum albumin level and pneumonia accounting for 6.48 % and 7.35 % of the total effect, respectively. The moderating effects of sex on dysphagia and the relationship between activities of daily living, modified Rankin scale score, and length of hospital stay were insignificant (ΔR = 0.063, P = 0.145; ΔR = 0.002, P = 0.620; ΔR = 0.001, P = 0.307).
Conclusions: Dysphagia can directly affect the prognostic outcomes of patients with stroke and indirectly affect prognosis by triggering pneumonia and lowering albumin levels. Sex was not found to play a moderating role in the relationship between dysphagia and prognosis.
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