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经灵活的内镜吞咽评估进行早期评估后进行营养干预与急性脑梗死患者的住院时间缩短相关:一项回顾性研究。

Nutritional intervention after an early assessment by a flexible endoscopic evaluation of swallowing is associated with a shorter hospital stay for patients with acute cerebral infarction: A retrospective study.

机构信息

Nutrition Support Team, National Hospital Organization Takasaki General Medical Center, Takasaki, Gunma, Japan.

Department of Oral and Maxillofacial Surgery, National Hospital Organization Takasaki General Medical Center, Takasaki, Gunma, Japan.

出版信息

Asia Pac J Clin Nutr. 2021 Jun;30(2):199-205. doi: 10.6133/apjcn.202106_30(2).0003.

Abstract

BACKGROUND AND OBJECTIVES

It is important to evaluate the swallowing function of patients with acute cerebral infarction. The effects of nutritional intervention after an early assessment by a flexible endoscopic evaluation of swallowing (FEES) were evaluated.

METHODS AND STUDY DESIGN

This retrospective study included 274 patients who were hospitalized for acute cerebral infarction and underwent a FEES between 2016 and 2018. The effects of early nutritional intervention after an assessment by a FEES within 48 h from admission were evaluated. The patients were divided into a shorter hospital stay group (<30 days) and a longer group (≥30 days). A multivariate analysis was performed to identify the predictive factors for a shorter hospital stay.

RESULTS

The overall patient characteristics were as follows: 166 men; median age, 81 years old; and median body mass index (BMI), 21.1 kg/m2. No significant differences in the age, sex, or BMI were found between the shorter and longer hospital stay groups. A FEES within 48 h of admission (odds ratio [OR], 2.040; 95% confidence interval [CI], 1.120-3.700; p=0.019), FILS level ≥6 at admission (OR, 2.300; 95% CI, 1.190-4.440; p=0.013), and an administered energy dose of ≥18.5 kcal/kg on hospital day 3 (OR, 2.360; 95% CI, 1.180-4.690; p=0.015) were independently associated with a hospital stay <30 days.

CONCLUSIONS

Patients with acute cerebral infarction are more likely to have a shorter hospital stay (<30 days) if they undergo a FEES early after admission and receive optimal nutritional intervention.

摘要

背景与目的

评估急性脑梗死患者的吞咽功能非常重要。本研究评估了在早期通过灵活的内镜吞咽功能评估(FEES)进行评估后,进行营养干预的效果。

方法和研究设计

本回顾性研究纳入了 2016 年至 2018 年期间因急性脑梗死住院并接受 FEES 检查的 274 例患者。评估了在入院后 48 小时内通过 FEES 进行评估后进行早期营养干预的效果。根据住院时间将患者分为较短组(<30 天)和较长组(≥30 天)。采用多变量分析确定较短住院时间的预测因素。

结果

患者的总体特征如下:166 例男性,中位年龄为 81 岁,中位体质指数(BMI)为 21.1kg/m2。较短和较长住院时间组之间的年龄、性别或 BMI 无显著差异。入院后 48 小时内行 FEES(优势比[OR],2.040;95%置信区间[CI],1.120-3.700;p=0.019)、入院时 FILS 评分≥6(OR,2.300;95%CI,1.190-4.440;p=0.013)和入院后第 3 天给予的能量剂量≥18.5kcal/kg(OR,2.360;95%CI,1.180-4.690;p=0.015)与住院时间<30 天独立相关。

结论

对于急性脑梗死患者,如果在入院后早期进行 FEES 检查并接受最佳营养干预,其更有可能住院时间较短(<30 天)。

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