Ikenaga Yasunori, Fudeya Masami, Kusunoki Tadayuki, Yamaguchi Hiromi
Department of Rehabilitation Medicine, Yawata Medical Center, Komatsu, Japan.
Council of Kaga Local Stroke Network, Nonoichi, Ishikawa, Japan.
Prog Rehabil Med. 2023 Mar 31;8:20230011. doi: 10.2490/prm.20230011. eCollection 2023.
This study investigated the factors contributing to complete oral intake (COI) in dysphagic stroke patients with enteral feeding tubes in the local clinical setting.
Data of patients with percutaneous endoscopic gastrostomy (PEG) or nasogastric tube (NGT) feeding on admission to convalescent rehabilitation wards (CRWs) were extracted from the Kaga Regional Cooperation Clinical Pathway for Stroke database for multiple centers including 19 acute care hospitals and 11 hospitals with CRWs. Patients were divided into two groups based on their status regarding COI or incomplete oral intake (ICOI) at discharge. Logistic regression analysis with forced-entry variables was used to identify factors contributing to COI.
On discharge from CRWs, COI and ICOI were observed in 140 and 207 cases, respectively. The COI group was younger, had a higher rate of initial stroke, higher Functional Oral Intake Scale (FOIS) scores, higher Functional Independence Measure (FIM) motor and cognitive scores, higher Body Mass Index (BMI), lower rate of patients with PEG, and shorter stays in acute care wards. Logistic regression analysis with forced entry revealed that younger age; initial stroke; higher FOIS score, FIM cognitive score, and BMI; and shorter stay in the acute care ward contributed to COI.
The primary factors contributing to COI in dysphagic stroke patients with enteral feeding tubes were younger age, initial stroke, higher swallowing and cognitive function, good nutritional status, and shorter stay in the acute care ward.
本研究调查了在当地临床环境中，经肠内喂养管进食的吞咽困难中风患者实现完全经口进食（COI）的相关因素。
从加贺地区中风多中心合作临床路径数据库中提取入住康复病房（CRWs）时采用经皮内镜下胃造口术（PEG）或鼻胃管（NGT）喂养的患者数据，该数据库涵盖19家急症医院和11家设有CRWs的医院。根据出院时的COI状态或不完全经口进食（ICOI）状态将患者分为两组。采用强制进入变量的逻辑回归分析来确定促成COI的因素。
从CRWs出院时，分别有140例和207例观察到COI和ICOI。COI组患者年龄较轻，初始中风发生率较高，功能口服摄入量量表（FOIS）得分较高，功能独立性测量（FIM）运动和认知得分较高，体重指数（BMI）较高，PEG患者比例较低，在急症病房的住院时间较短。强制进入的逻辑回归分析显示，年龄较小、初始中风、较高的FOIS得分、FIM认知得分和BMI，以及在急症病房的住院时间较短促成了COI。
经肠内喂养管进食的吞咽困难中风患者实现COI的主要因素是年龄较小、初始中风、较高的吞咽和认知功能、良好的营养状况，以及在急症病房的住院时间较短。
