Post-stroke dysphagia using the GUSS test: clinical-epidemiological analysis in Honduran referral hospitals, February-May 2025

Abstract

Introduction: Dysphagia is a swallowing disorder that hinders the oral preparation of the bolus or its transport to the stomach; it is a common complication in stroke patients due to neurological damage that alters the phases of swallowing. Rates of up to 50% have been reported in acute stroke. Objective: To describe the clinical and epidemiological characteristics of dysphagia in patients hospitalized with stroke in four national referral hospitals, February–May 2025. Methods: A descriptive cross-sectional multicenter study with convenience sampling was conducted on patients ≥18 years of age with a confirmed diagnosis of stroke, following inclusion/exclusion criteria. An interview-type survey was used to identify dysphagia and its severity using the Gugging Swallowing Screen (GUSS) test. Univariate analysis (frequencies, percentages, measures of central tendency/dispersion) and bivariate analysis using multivariate linear regression were performed (p-value<0.05 and 95% CI were considered significant). Approval was obtained from the ethics committee. Results: Eighty-nine stroke patients were evaluated, of whom 74.2% (66/89) had dysphagia; 62.1% of which was moderate-tosevere dysphagia with the most frequent symptoms being throat clearing (66.7%), wet voice (57.6%), and post-swallowing cough (51.5%). Affected cranial nerves: facial 81.8%, glossopharyngeal 65.1%, vagus 47%, spinal 33.3%, and hypoglossal 24.2%. The GUSS score was directly related to cognitive level on the Rancho Los Amigos Scale (ß=2.01) and negatively related to the presence of motor aphasia (ß= -3.72), orofacial apraxia (ß= -3.60), and age (ß= -0.063), p<0.05. Discussion: The proportion of dysphagia was high, being moderate to severe and this severity was associated with biological, neurological and cognitive factors. It is recommended that interdisciplinary assessment and care protocols be implemented for a comprehensive approach.