City Research Online

Abstract

Study Design
Systematic Review.

Objectives
This systematic review aimed to summarise evidence on the risk factors associated with dysphagia for people with Cervical Spinal Cord Injury (cSCI).

Setting
Studies originate from multiple countries, no single study setting applies.

Methods
We searched Medline and Embase (OVID), CENTRAL, CINAHL (EBSCOhost), Web of Science (Clarivate), ProQuest and Scopus on 16 January 2025 with an update on 27 July 2025 for prospective and retrospective cohort studies, cross-sectional and non-randomised observational longitudinal studies. These studies included patients aged ≥ 16 years with cSCI and no pre-existing oropharyngeal dysphagia or oesophageal dysphagia. Following standard Cochrane review methodology, two reviewers screened the search results and the full text papers of potentially relevant studies independently and then assessed methodological quality using Newcastle Ottawa Scale (NOS). The certainty of evidence was appraised using Grading of Recommendations, Assessments, Development and Evaluations (GRADE). Data were extracted using a piloted tool. Meta-analysis for each risk factor was conducted using RevMan, pooling Odds Ratios (ORs) from multivariate and univariate models.

Results
Eighteen studies (2, 258 participants) were included. Our meta-analyses suggested that three risk factors had significant associations with dysphagia in cSCI: tracheostomy (OR = 4.91, 95% CI: 1.74 to 13.86, p = 0.003); being male (OR = 1.95, 95% CI:1.32 to 2.55, p = 0.0009) and combined anterior-posterior surgery (OR = 1.77, 95% CI: 1.17 to 2.70, p = 0.007). Other risk factors with promising but limited data included nasogastric tube presence.

Conclusions
There is very low certainty evidence that the risk factor groups of tracheostomy, male gender and combined anterior-posterior neck surgery can predict dysphagia in cSCI. More robust and large-scale research with standardised outcome measures is required to explore the independent prognostic factors of dysphagia in cSCI.

Publication Type:	Article
Additional Information:	© The Author(s) 2026. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
Subjects:	R Medicine > RC Internal medicine
Departments:	School of Health & Medical Sciences School of Health & Medical Sciences > Department of Allied Health
SWORD Depositor:	Symplectic Administrator

Export

Downloads