Abstract
Background: Infection is a common complication after stroke and is strongly associated with an unfavorable functional outcome of patients. Although nutritional intervention reduces the risk of post-operative infection, the impact of differences of products has not been clarified. Less examination of infection and use of antibiotics not only show a high-quality care. In DPC hospital (Japanese style of DRG / PPS), it is important from the hospital management point of view to reduce the comprehensive costs such as medicines and inspections as much as possible. The purpose of this study is to investigate whether the selection of enteral nutrition in the acute phase of stroke patients can contribute to inflectional control and hospital costs. Methods: Retrospective analysis in a single center was performed in 50 acute stroke patients who were received enteral nutrition from April 2017 to March 2019. Nutrients gradually over 7 days of hospitalization, the patients were classified into two groups: 1.0-group (general nutrition 1.0 kcal/mL, 25 patients) and 1.5+α-group (started with high protein whey peptide-digested liquid diet (1.5 kcal/mL) and were, later, switched to highly fermentable dietary fiber contained liquid diet (1.5 kcal/mL) after 4 days, 25 patients). Lengths of hospital stay, days of antibiotic use (except during intraoperative), serious infection including methicillin-resistant Staphylococcus aureus , Extended spectrum β -lactamase producing Enterobacteriaceae and Clostridium difficile infection, and total medical costs were analyzed. Results: The baseline characteristics were similar in the both groups. The mean of lengths of hospital stay were 48.0 and 47.8 days in 1.0-group and 1.5+α-group, respectively. The mean of days of antibiotics use during hospitalization in 1.0-group (16.5 days (34.4%)) were larger than that in 1.5+α-group (11.3 days (23.6%)). The serious infections were developed in six and four cases in 1.0-group and 1.5+α-group, respectively. The total hospital costs were reduced by approximately 500 USD/patient in 1.5+α group as compared to 1.0 group. Conclusions: The selection of enteral nutrition in the acute phase of stroke patients affects the risk of in-hospital infection and reduces hospital costs.
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