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☐ ☆ ✇ BMJ Open

Cost analysis of post-stroke dysphagia during acute hospitalisation: a cross-sectional study in Vietnam

Por: Thong · T. H. · Hien · N. T. T. · Tung · L. T. · Thang · P. · Trung · T. H. · Tien · V. D. · Hanh · H. T. · Lam · T. H. — Octubre 8th 2025 at 05:59
Objectives

To estimate the healthcare costs associated with post-stroke dysphagia during acute hospitalisation and to identify factors influencing these costs in a tertiary hospital setting in Vietnam.

Design

A cross-sectional study using clinical and billing data from hospital records.

Setting

The study was conducted at the Neurology Center of Bach Mai Hospital, a tertiary care facility in Hanoi, Vietnam, between June 2020 and January 2022.

Participants

A total of 951 patients aged ≥18 years with acute ischaemic stroke confirmed by CT or MRI were included. Dysphagia was assessed using the Gugging Swallowing Screen.

Outcome measures

Direct healthcare costs during hospitalisation were collected from the hospital billing system and categorised as medications, diagnostic imaging, medical supplies, accommodation, food, procedures and laboratory tests. All costs were converted to USD. Associations between patient characteristics and total healthcare costs were analysed using generalised linear models (Gamma distribution with log link), applying robust standard errors.

Results

The median treatment cost was 10.08 million VND (436.24 USD) in the dysphagia group vs 6.37 million VND (275.78 USD) in the non-dysphagia group. Costs increased with dysphagia severity, reaching 22.64 million VND (979.49 USD) among patients with severe dysphagia. In multivariate analysis, dysphagia was associated with a 21% increase in costs (exp(β) = 1.21; 95% CI 1.10 to 1.33; p14, pneumonia, prolonged hospitalisation and higher educational level.

Conclusions

Post-stroke dysphagia substantially increases acute hospitalisation costs in Vietnam. Early screening, standardised management and preventive care for complications may improve outcomes and reduce costs.

Trial registration number

The study was registered on the Research Registry website (https://www.researchregistry.com/) under the unique identification number: researchregistry8203.

☐ ☆ ✇ BMJ Open

Outcomes of 16 weeks of combined exercises on Cobb angle, bone and muscle health, and quality of life in females with idiopathic scoliosis: a study protocol for a single-blinded randomised controlled trial

Por: Wannakon · T. · Sitilertpisan · P. · Tungjai · M. · Thawinchai · N. — Agosto 14th 2025 at 04:49
Introduction

Scoliosis-specific exercises require specialist supervision, frequent clinical visits, and high costs, limiting accessibility. Additionally, females with idiopathic scoliosis (IS) engage in less physical activity (PA) than sex- and age-matched peers, leading to poorer bone and muscle health. These challenges underscore the need for accessible, home-based interventions targeting both musculoskeletal health and spinal alignment.

Methods and analysis

This single-blinded, randomised controlled trial aims to investigate the efficacy of a 16-week home-based exercise intervention on bone mineral density (BMD), Cobb angle, spinal flexibility, core muscle endurance, lean body mass, and quality of life (QoL) in females with IS. 28 participants will be randomly assigned (1:1) to either an intervention group (IG) or a control group (CG). Both groups will perform Schroth and core stabilisation exercises three times per week, while the IG will additionally perform impact-loading exercises. The primary outcome is BMD. Secondary outcomes include Cobb angle, lean body mass, cosmetic trunk deformity, spinal flexibility, core muscle endurance, and QoL. All outcomes will be assessed at baseline and post-intervention, with interim evaluations (excluding BMD, Cobb angle, and lean body mass) conducted at weeks 4, 8, and 12. All assessors, radiologists, and statisticians will remain blinded to group allocation. Treatment effects between groups over time will be analysed using two-way mixed-design analysis of variance (ANOVA).

Discussion

This study addresses a critical gap in IS management by integrating a preventive and therapeutic home-based programme. The approach aims to improve musculoskeletal health, spinal alignment, and overall QoL. Its accessible format may inform future guidelines for conservative treatment and early intervention. Such interventions could significantly enhance bone health, reduce the risk of progression, and improve long-term musculoskeletal outcomes in young females with mild to moderate IS.

Ethics and dissemination

This study has received ethical approval from the Research Ethics Committee, Faculty of Associated Medical Sciences, Chiang Mai University (No. AMSEC-67EX-045). The findings will be disseminated through a peer-reviewed publication.

Trial registration number

TCTR20241001001.

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