Author(s)
Jennifer Gottfried
Ryan Kong
Sara Abu-Ghanem
Affiliation(s)
College of Medicine, SUNY Downstate Health Sciences University, Brooklyn, NY; Department of Otolaryngology, SUNY Downstate Health Sciences University, Brooklyn, NY; Division of Otolaryngology, Maimonides Medical Center, Brooklyn, NY;
Abstract:
Objective: Post-stroke vocal fold motion impairment (VFMI) has previously been described. However, the incidence and any risk factors are unknown. This study aimed to assess the incidence of vocal fold paralysis and paresis after stroke, as well as the risk factors associated with development of post-stroke VFMI.
Method: A query of the 2009-2013 New York State SPARCS database was performed using ICD9 codes for adult patients with acute ischemic stroke and intracerebral hemorrhagic stroke with at least one year of follow-up. Chi-square with post-hoc column proportion testing was performed for univariate analysis of patient demographics and comorbidities. Multivariable logistic regression analysis was used to determine odd ratios of developing VFMI after stroke controlling for patient demographics and comorbidities. Significance was set at an alpha level of < 0.05. Analyses were performed in SPSS version 28.
Results: A total of 20,919 stroke patients were isolated. 83 (0.4%) patients were diagnosed with VFMI after stroke diagnosis. Times to diagnosis of VFMI were within admission of stroke, 16 (19.3%); within 1 year, 28 (33.7%); between 1-2 years, 18 (21.7%); and more than 2 years: 21 (25.3%). VFMI patients had higher rates of coagulopathies (8.4% vs 3.4%; p=0.023) and age 40-59 years old (26.5% vs 17.8%; p<0.05) compared to non-VFMI patients. Rates of gender, race/ethnicity, payer type, obesity, alcohol abuse, deficiency anemias, congestive heart disease, chronic pulmonary disease, diabetes, drug abuse, hypertension, hypothyroidism, renal failure, and peripheral vascular disease are similar (p>0.05). Multivariate analysis showed that VFMI patients have an increased odds ratio of pre-existing coagulopathies (OR 2.62; 95% CI 1.19-5.76; p=0.017).
Conclusion: VFMI is a rare complication after stroke, most often diagnosed 1 or more years after stroke. More research is needed to understand the risk factors that place patients at a higher risk of VFMI following stroke and aid in early screening/intervention.