Department of Rehabilitation Medicine II, School of Medicine, Fujita Health University, Mie, Japan.
J Stroke Cerebrovasc Dis. 2013 Oct;22(7):926-930.e1. doi: 10.1016/j.jstrokecerebrovasdis.2013.04.003. Epub 2013 May 13.
The long-term prognosis of eating and swallowing disability has not been fully clarified. As community-based stroke care systems have developed in Japan, these data have become available.
We examined changes in nutritional intake using data acquired from a community-based stroke care system. There were 334 stroke patients who were discharged from our acute care hospital and transferred to rehabilitation hospitals with tube feeding. We examined the relationship between the initial bedside swallowing assessment and the method of nutrition delivery at discharge from a rehabilitation hospital. We also calculated the functional independent measure (FIM) to examine the relationship between activities of daily living and nutritional intake.
There were 291 patients on oral intake and 43 on enteral feeding at discharge from a rehabilitation hospital. Patients with enteral feeding were older than patients with oral intake (69.4 ± 11.4 v 75.2 ± 9.9 years; P = .0016). The enteral feeding group also had lower FIM gain (27.5 ± 28.3 v 16.5 ± 23.5; P = .0161) and FIM efficiency (1.10 ± 1.24 v 0.65 ± 1.26; P = .0270) at the acute care hospital.
Age, FIM gain, and FIM efficacy in the acute care hospital reliably predicted the long-term prognosis of eating and swallowing disability.
进食和吞咽障碍的长期预后尚未完全阐明。随着日本社区为基础的脑卒中护理系统的发展，这些数据已经可用。
我们使用从社区为基础的脑卒中护理系统中获取的数据，检查了营养摄入的变化。共有 334 名脑卒中患者从我们的急性护理医院出院，并转至康复医院进行管饲。我们检查了初始床边吞咽评估与康复医院出院时营养输送方式之间的关系。我们还计算了功能独立性测量（FIM），以检查日常生活活动与营养摄入之间的关系。
有 291 名患者在康复医院出院时经口进食，43 名患者经肠内喂养。接受肠内喂养的患者比经口进食的患者年龄更大（69.4±11.4 岁比 75.2±9.9 岁；P=0.0016）。肠内喂养组在急性护理医院的 FIM 获益（27.5±28.3 分比 16.5±23.5 分；P=0.0161）和 FIM 效率（1.10±1.24 分比 0.65±1.26 分；P=0.0270）也更低。
年龄、急性护理医院的 FIM 获益和 FIM 效率可可靠预测进食和吞咽障碍的长期预后。
