影响康复病房内肠内喂养管吞咽困难脑卒中患者完全口服摄入的因素。

Yasunori Ikenaga, Masami Fudeya, Tadayuki Kusunoki, Hiromi Yamaguchi
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摘要

目的:本研究探讨了在当地临床环境中影响吞咽困难脑卒中患者肠内喂养管完全口服摄入(COI)的因素。方法:将经皮内镜胃造口术(PEG)或鼻胃管(NGT)患者在康复病房(CRWs)入院时进食的数据提取自加加地区卒中合作临床路径数据库,该数据库包括19家急症护理医院和11家CRWs医院。根据患者出院时COI或不完全口服摄入(ICOI)的情况将患者分为两组。使用强行进入变量的逻辑回归分析来确定导致COI的因素。结果:CRWs出院时出现COI 140例,ICOI 207例。COI组更年轻,有更高的初始卒中率,更高的功能性口服摄入量表(FOIS)评分,更高的功能独立测量(FIM)运动和认知评分,更高的身体质量指数(BMI),更低的PEG患者率,更短的急性护理病房住院时间。有强行进入的Logistic回归分析显示年龄更小;最初的中风;较高的FOIS评分、FIM认知评分和BMI;急性监护病房的住院时间较短有助于COI。结论:肠内喂养管吞咽困难脑卒中患者发生COI的主要因素是年龄较小、初次卒中、吞咽和认知功能较高、营养状况良好、急症病房住院时间较短。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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Factors Contributing to Complete Oral Intake in Dysphagic Stroke Patients with Enteral Feeding Tubes in Convalescent Rehabilitation Wards.

Objectives: This study investigated the factors contributing to complete oral intake (COI) in dysphagic stroke patients with enteral feeding tubes in the local clinical setting.

Methods: 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.

Results: 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.

Conclusions: 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.

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