Marianjoy Rehabilitation Hospital, Department of Speech-Language Pathology, Wheaton, Illinois, USA.
Top Stroke Rehabil. 2010 May-Jun;17(3):197-203. doi: 10.1310/tsr1703-197.
To identify the frequency and characteristics of patients admitted to inpatient rehabilitation (IPR) following a stroke who are able return to oral feedings and have their feeding tube (FT) removed prior to discharge from IPR, the timing of FT removal, and implications for outcomes.
Medical records were identified by admission rehabilitation impairment code (RIC) for stroke (RIC 01), and reviews were completed by two physiatrists and two speech language pathologists. At random, 25% of the charts were reviewed by a second rater for data quality control. Measures collected during the chart review included the following: age, gender, onset of stroke, rehabilitation length of stay (LOS), admission and discharge FIM, discharge destination, diet level, and feeding tube status.
One hundred forty-three patients were identified as subjects for this investigation who had an FT and were NPO upon IPR admission. Overall, 46.9% (67/143) of the patients returned to three meals daily prior to discharge from IPR. The mean days post stroke onset until returning to three meals daily was 38.43 days (SD=26.36). Twenty percent (30/143) of the patients were able to have their FT tube removed prior to discharge from IPR. Factors associated with returning to three meals included gender (ie, female), longer IPR LOS, and higher admission FIM scores at IPR. Factors associated with removal of the feeding tube included a longer IPR LOS and younger age. Patients who were able to have their FT removed were more likely to be discharged to home.
Individuals with longer IPR LOS were more likely to return to three meals daily and have their feeding tubes removed prior to discharge.
确定在接受住院康复治疗（IPR）的中风患者中，有多少患者能够在出院前恢复口服喂养并拔除喂养管（FT），FT 的拔除时间以及对结果的影响。
通过中风的入院康复损伤代码（RIC 01）识别病历，并由两名物理治疗师和两名言语语言病理学家进行审查。随机抽取 25%的病历由第二位评估员进行数据质量控制审查。在病历审查期间收集的措施包括：年龄、性别、中风发作时间、康复住院时间（LOS）、入院和出院 FIM、出院目的地、饮食水平和喂养管状况。
确定了 143 名有 FT 且 IPR 入院时禁食的患者作为本研究的对象。总体而言，46.9%（67/143）的患者在从 IPR 出院前恢复了每日三餐。从中风发作到恢复每日三餐的平均天数为 38.43 天（SD=26.36）。20%（30/143）的患者能够在从 IPR 出院前拔除 FT 管。与恢复每日三餐相关的因素包括性别（即女性）、较长的 IPR LOS 和较高的 IPR 入院 FIM 评分。与拔除喂养管相关的因素包括较长的 IPR LOS 和较年轻的年龄。能够拔除 FT 的患者更有可能被出院回家。
IPR LOS 较长的患者更有可能恢复每日三餐并在出院前拔除喂养管。
