Dysphagia is often a long-term problem after ischemic stroke, which are often accompanied by complications and results in poor outcome. This study aimed to investigate the influencing factors associated with the prognosis of dysphagia after senile ischemic stroke and evaluate the diagnostic performance of crucial factors. A total of 192 elderly ischemic stroke patients (96 patients without dysphagia with average age of 69.81 ± 4.61 years and 96 patients with dysphagia with average of 70.00 ± 6.66 years) were enrolled in the retrospective study. The clinical factors of the patients were collected and recorded for chi-square analysis and logistic analysis. The receiver operating characteristic (ROC) curve was performed to evaluate the diagnostic performance of international normalized ratio (INR) and homocysteine (Hcy) in senile ischemic stroke patients. The age, cough reflex, history of stroke, mechanical ventilation, eating posture, insufficient elevation of the larynx, standard swallowing assessment (SSA) score, Hcy value, and INR were closely related to endpoint events of patients with dysphagia. The joint model (combined INR and Hcy value) can increase the area under the curve (AUC) value (0.948) with higher sensitivity and specificity for predicting patients with dysphagia occurred endpoint events. The influencing factors for older ischemic stroke patients with dysphagia include age, cough reflex, history of stroke, mechanical ventilation, eating posture, insufficient elevation of the larynx, SSA score, Hcy value, and INR. INR and Hcy were independent risk factors for prognosis and diagnostic markers for patients with dysphagia after senile ischemic stroke.

吞咽困难往往是缺血性中风后的一个长期问题，常伴有并发症并导致预后不良。本研究旨在探讨老年缺血性脑卒中后吞咽困难预后的影响因素，并评估关键因素的诊断性能。回顾性研究共纳入192例老年缺血性脑卒中患者（无吞咽困难患者96例，平均年龄69.81±4.61岁，有吞咽困难患者96例，平均年龄70.00±6.66岁）。收集并记录患者的临床因素进行卡方分析和Logistic分析。采用受试者工作特征（ROC）曲线评价国际标准化比值（INR）和同型半胱氨酸（Hcy）对老年缺血性脑卒中患者的诊断性能。年龄、咳嗽反射、脑卒中病史、机械通气、进食姿势、喉部抬高不足、标准吞咽评估（SSA）评分、Hcy值、INR与吞咽困难患者的终点事件密切相关。联合模型（结合INR和Hcy值）可以增加曲线下面积（AUC）值（0.948），对于预测吞咽困难患者发生的终点事件具有更高的敏感性和特异性。老年缺血性脑卒中患者吞咽困难的影响因素包括年龄、咳嗽反射、脑卒中病史、机械通气、进食姿势、喉部抬高不足、SSA评分、Hcy值、INR。 INR和Hcy是老年缺血性脑卒中后吞咽困难患者预后的独立危险因素和诊断标志物。