Prevalence and risk factors for postextubation dysphagia in ICU patients with orotracheal intubation: a systematic review and meta-analysis

Background Evidence suggests that 41% of ICU patients acquired postextubation dysphagia, substantially increasing the risk of aspiration and malnutrition. Studies on its prevalence and risk factors showed considerable variation. Our study aims to summarize the overall prevalence and identify risk factors for postextubation dysphagia in ICU patients undergoing orotracheal intubation. Methods We searched PubMed, Embase, Web of Science, Cochrane Library, CINAHL, Medline, China National Knowledge Infrastructure, Wanfang, SinoMed, and Technology Journal Database for studies on postextubation dysphagia from inception to July 5, 2025. Two researchers independently conducted the literature screening, quality assessment, and extracted data. Meta-analysis was performed using Stata software 18.0 and Review Manager software 5.3. Results Twenty-five studies were included, encompassing a total of 7,219 patients. The meta-analysis revealed that the overall prevalence of postextubation dysphagia was 35% (95% CI: 25–46). Age (OR = 1.03), age ≥ 65 years (OR = 2.72), age ≥ 70 years (OR = 2.34), Acute Physiology and Chronic Health Evaluation II (APACHE II) score (OR = 1.29), APACHE II score ≥ 15 points (OR = 4.69), arrhythmia (OR = 3.30), neurological disorders (OR = 3.77), tracheal intubation duration in hours (OR = 1.03), tracheal intubation duration in days (OR = 1.13), tracheal intubation duration ≥72 h (OR = 8.15), tracheal intubation duration ≥7 days (OR = 2.06), gastric tube retention (OR = 6.59), and gastric tube retention duration ≥72 h (OR = 3.43), emergency admission (OR = 2.30) were risk factors for postextubation dysphagia. Conclusion The incidence of PED in ICU patients is relatively high, which is influenced by various factors. Based on the identified risk factors, clinical staff can early identify high-risk individuals and implement targeted preventive measures to avoid postextubation dysphagia. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/ , CRD420251090144.