Department of Rehabilitation Medicine, Nagoya Medical Centre, Aichi, Japan.
Department of Physical Therapy, Gifu University of Health Science, Gifu, Japan.
Int J Speech Lang Pathol. 2024 Aug;26(4):584-594. doi: 10.1080/17549507.2023.2221408. Epub 2023 Jun 26.
We investigated the association between the time to first post-extubation oral intake, barriers to oral intake, and the rate of activities of daily living (ADL) independence at discharge (Barthel Index score <70).
Consecutive patients admitted to the intensive care unit, aged ≥18 years, and mechanically ventilated for ≥48 hr were retrospectively enrolled. The time to first oral intake, barriers to oral intake, daily changes, and clinical outcomes were assessed. Multiple logistic regression analysis adjusted for baseline characteristics was used to determine the association between time to first post-extubation oral intake and ADL independence.
Among the 136 patients, 74 were assigned to the ADL independence group and 62 to the dependence group. The time to first post-extubation oral intake was significantly associated with ADL independence (adjusted = < 0.001) and was a predictor of ADL independence at discharge. Respiratory and dysphagia-related factors (odds ratio [OR] 0.35; 95% confidence interval [CI] 0.15-0.82, = 0.015 and OR 0.07; CI 0.01-0.68, = 0.021, respectively) were significantly associated with the ADL independence at discharge.
Respiratory and dysphagia-related factors, as barriers to the initiation of oral intake after extubation, were significantly associated with ADL independence at discharge.
我们研究了首次经口摄食时间、经口摄食障碍与日常生活活动（ADL）独立性（Barthel 指数评分＜70）之间的关系。
回顾性纳入连续入住重症监护病房、年龄≥18 岁且机械通气时间≥48 小时的患者。评估首次经口摄食时间、经口摄食障碍、每日变化和临床结局。采用多因素逻辑回归分析调整基线特征，以确定首次经口摄食与 ADL 独立性之间的关系。
在 136 例患者中，74 例患者被分配到 ADL 独立组，62 例患者被分配到 ADL 依赖组。首次经口摄食时间与 ADL 独立性显著相关（调整后 = ＜0.001），并可预测出院时的 ADL 独立性。呼吸和吞咽相关因素（比值比 [OR] 0.35；95%置信区间 [CI] 0.15-0.82， = 0.015 和 OR 0.07；CI 0.01-0.68， = 0.021）与出院时的 ADL 独立性显著相关。
作为拔管后开始经口摄食的障碍，呼吸和吞咽相关因素与出院时的 ADL 独立性显著相关。
