Abstract Introduction: dysphagia is a common complication of stroke, and serum albumin is widely recognized as a strong prognostic marker of health and/or disease status. However, the correlation between dysphagia and serum albumin levels has not been established. Objectives: to observe the correlation between dysphagia and serum albumin levels and prognosis in patients with stroke. Methods: we performed a retrospective study of patients hospitalized between June 1, 2018, and June 1, 2022. A total of 1,370 patients were enrolled. The patients were divided into two groups: dysphagia and non-dysphagia. Binary logistic regression and multiple linear regression models were used to analyze the correlation between dysphagia, albumin, modified Rankin Scale (mRS), activities of daily living (ADL), and length of hospital stay (LOS). Results: after adjusting for confounding factors, the risk of pneumonia in the dysphagia group was 2.417 times higher than that in the non-dysphagia group (OR = 2.417, 95 % CI: 1.902-3.072, p = 0.000). The risk of mRS ≥ 3 and modified Barthel index (MBI) < 60 in patients with dysphagia was 3.272-fold (OR = 3.272, 95 % CI: 2.508-4.269, p < 0.001) and 1.670-fold (OR = 1.670, 95 % CI: 1.230-2.268, p < 0.001), respectively; and the risk of hypoproteinemia was 2.533 times higher (OR = 2.533, 95 % CI: 1.879-3.414, p = 0.000). Stepwise linear regression showed that dysphagia was significantly correlated with lower albumin levels and higher mRS, lower ADL, and longer LOS in patients with stroke (β = -0.220, β = 0.265, β = -0.210, and β = 0.147, respectively; p < 0.001). Conclusions: dysphagia in patients with stroke is associated with decreased albumin levels and has an impact on its prognosis.

Resumen Introducción: la disfagia es una complicación común del accidente cerebrovascular, y la albúmina sérica es ampliamente reconocida como un fuerte marcador pronóstico del estado de salud y/o enfermedad. Sin embargo, no se ha establecido la correlación entre la disfagia y los niveles de albúmina sérica. Objetivos: observar la correlación entre la disfagia y los niveles de albúmina sérica y el pronóstico en pacientes con accidente cerebrovascular. Métodos: realizamos un estudio retrospectivo de pacientes hospitalizados entre el 1 de junio de 2018 y el 1 de junio de 2022. Se inscribieron un total de 1.370 pacientes, los cuales fueron divididos en dos grupos: con disfagia y sin disfagia. Se utilizaron modelos de regresión logística binaria y de regresión lineal múltiple para analizar la correlación entre la disfagia, la albúmina, la escala de Rankin modificada (ERm), las actividades de la vida diaria (AVD) y el tiempo de estancia hospitalaria (TEH). Resultados: después de ajustar por factores de confusión, el riesgo de neumonía en el grupo de disfagia fue 2,417 veces mayor que en el grupo sin disfagia (OR = 2,417, IC 95 %: 1,902-3,072, p = 0,000). El riesgo de ERm ≥ 3 y el índice de Barthel modificado (MBI) < 60 en pacientes con disfagia se multiplicó por 3,272 veces (OR = 3,272, IC 95 %: 2,508-4,269, p < 0,001) y 1,670 veces (OR = 1,670, IC 95 %: 1,230-2,268, p < 0,001), respectivamente; el riesgo de hipoproteinemia fue 2,533 veces mayor (OR = 2,533, IC 95 %: 1,879-3,414, p = 0,000). La regresión lineal por pasos mostró que la disfagia se correlacionó significativamente con niveles más bajos de albúmina y ERm más altos, AVD más bajos y TEH más prolongados en pacientes con accidente cerebrovascular (β = -0,220, β = 0,265, β = -0,210 y β = 0,147, respectivamente; p < 0,001). Conclusiones: la disfagia en pacientes con accidente cerebrovascular se asocia a una disminución de los niveles de albúmina y repercute en su pronóstico.

OBJECTIVES: This pilot study investigated the safety and efficacy of a novel shunt surgery combined with foam sclerotherapy of varices in patients with prehepatic portal hypertension. METHODS: Twenty-seven patients who were diagnosed with prehepatic portal hypertension and underwent shunt surgeries were divided into three groups by surgery type: shunt surgery alone (Group A), shunt surgery and devascularization (Group B), and shunt surgery combined with foam sclerotherapy (Group C). Between-group differences in operation time, intraoperative blood loss, portal pressure decrease, postoperative complications, rebleeding rates, encephalopathy, mortality rates and remission of gastroesophageal varices were compared. RESULTS: Groups A, B and C had similar operation times, intraoperative bleeding, and portal pressure decrease. The remission rates of varices differed significantly (p<0.001): one patient in Group A and 6 patients in Group B had partial response, and all 9 patients in Group C had remission (2 complete, 7 partial). Two Group A patients and one Group B patient developed recurrent gastrointestinal bleeding postoperatively within 12 months. No postoperative recurrence or bleeding was observed in Group C, and no sclerotherapy-related complications were observed. CONCLUSIONS: Shunt surgery combined with foam sclerotherapy obliterates varices more effectively than shunt surgery alone does, decreasing the risk of postoperative rebleeding from residual gastroesophageal varices. This novel surgery is safe and effective with good short-term outcomes.