Abstract
Objective: Although the importance of early tube feeding after stroke has been established, many risks and problems such as negative impacts on swallow function, respiratory infections and feeling uncomfortable, also warrant attention. The trajectory of swallowing function recovery may be related to each patient’s characteristics. There is still no systematic predictors for clinical decision-making regarding oral feeding resumption. The aim is to explore predictors of complete oral feeding resumption after feeding tube with stroke based on the modified V-VST. Methods: A total of 86 stroke patients with tube feeding were enrolled after admission in rehabilitation hospital from 2020 to 2021. The swallowing function was screened with modified V-VST. If a patient complete every viscosity more than 5ml, feeding tube will be removed. Oral feeding was begun using mechanical soft diet and thickener to ensure every meal safe. 55 patients(63.95%) resumed complete oral intake, while 31 patients(36.05%) presented a more permanent way of tube feeding. We compared the baseline and clinical characteristics between the groups. To analyze oral feeding resumption probability, the Kaplan-Meier method was used. Results: The days of onset to rehabilitation hospital admission was significantly shorter in the complete oral resumption group(20.89±11.27 vs 37.16±27.37; P<0.001). The group was also measured better performance in activities of daily living (Barthel Index). Patients in the tube feeding group have high rate of previous stroke. Kaplan-Meier estimated oral feeding resumption rates, patients with longer days(>21days) tolerated tube feeding longer.(P<0.001). Conclusion: Days of onset to rehabilitation hospital was the strongest predictor of complete oral feeding resumption. Patients might benefit from early recovery in rehabilitation hospital and start oral intake as early as possible.
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