Pharyngeal Electrical Stimulation for Treatment of Poststroke Dysphagia: Individual Patient Data Meta-Analysis of Randomised Controlled Trials

Table 3

Comparison of outcomes at 2 weeks and discharge from hospital in 73 patients across three trials by treatment assignment (pharyngeal electrical stimulation versus sham/placebo). Data are number (%), median [interquartile range], or mean (standard deviation). Comparison by binary logistic regression (BLR), ordinal logistic regression (OLR), or multiple regression (MR), with 95% confidence intervals. Adjustment: full model is adjusted for trial, relevant baseline score, age, and impairment (NIHSS); partial model is adjusted for trial only.

	Trials/patients	PES	Sham	Difference/odds ratio (95% CI)	2	Difference/odds ratio (95% CI)	2
Statistical model		37	36	Adjusted, full		Adjustment, trial
2 weeks
PAS (/8)	3/55	3.4 (1.7)	4.1 (1.7)	−0.9 (−1.7, −0.1)	0.020	−0.7 (−1.6, 0.2)	0.13
Mean of first three	3/55	3.2 (1.7)	3.9 (1.9)	−0.9 (−1.7, 0.0)	0.044	−0.6 (−1.5, 0.3)	0.19
Cumulative (/48)	3/54	19.3 (9.6)	24.4 (10.4)	−6.0 (−10.7, −1.4)	0.011	−4.7 (−9.8, 0.5)	0.078
Number of boli >3	3/55	2.2 (2.1)	3.3 (2.0)	−1.4 (−2.2, −0.6)	<0.001	−1.0 (−2.1, 0.0)	0.055
Any bolus >3 (%)	3/55	22 (75.9)	24 (92.3)	0.05 (0, 0.96)	0.047	0.26 (0.05, 1.49)	0.13
Worst [/8]	3/55	5 []	6 []	0.37 (0.11, 1.18)	0.092	0.7 (0.27, 1.81)	0.46
DSRS (/12)	2/63	3.5 (3.8)	4.9 (4.4)	−1.7 (−3.2, −0.1)	0.040	−1.3 (−3.3, 0.7)	0.19
Score >3 (%)	2/63	10 (30.3)	16 (53.33)	0.25 (0.07, 0.89)	0.032	0.39 (0.14, 1.10)	0.075
Score >7 (%)	2/63	6 (18.2)	7 (23.3)	0.54 (0.12, 2.36)	0.41	0.79 (0.23, 2.78)	0.71
NIHSS (/42)	2/44	7.9 (5.6)	9.1 (8.5)	0.4 (−2.5, 3.4)	0.77	−1.1 (−5.2, 3.1)	0.62
Died (%)	1/35	0 (0)	1 (5.6)	—	—	—	—
RTI (%)	2/63	4 (12.1)	4 (13.3)	—	—	0.83 (0.18, 3.74)	0.81
Discharge
Hospital stay (days)	3/73	50.2 (25.3)	71.2 (60.4)	−16.2 (−36.2, 3.7)	0.11	−18.5 (−39.0, 1.9)	0.075
Died, in hospital (%)	1/35	0 (0)	1 (5.6)	—	—	—	—
Died, end of trial (%)	1/35	1 (5.9)	1 (5.6)	1.2 (0.1, 25.8)	0.91	1.1 (0.1, 18.5)	0.97

Scores for death: DSRS = 13, NIHSS = 43, and PAS = 9.
DSRS: dysphagia severity rating scale; NIHSS: National Institutes of Health Stroke Scale; PAS: penetration aspiration score; RTI: respiratory tract infection (chest infection or pneumonia).