Abstract WMP34: Impact of Complete Oral Feeding Resumption on Nutrition and Hydration in the Rehabilitation Inpatient With Stroke

Abstract

Objective: Oral feeding resumption after feeding tube placement is an important therapeutic goal for stroke patients with dysphagia. Available information on nutrition and hydration status in stroke is limited after changing intake from commercial formula for tube feeding to dysphagia diet for oral. The aim is to explore the impact on nutrition and hydration after complete oral feeding. Methods: A total of 134 stroke patients who recovered from tube feeding to complete oral feeding were enrolled in rehabilitation hospital from Jan. 2020 to Jul. 2023. The swallow function was detected by the modified Volume-viscosity Swallow Test (V-VST). If a patient completed every viscosity more than 5 mL, feeding tube would be removed. We assessed the nutritional status of stroke patients and provided strategies of dysphagia diet for patients’ food and fluid intakes. Thickeners were used to prevent the risk of aspiration. Serum biochemical measures were obtained for nutrition (prealbumin) and hydration status (BUN/Cr ratio) at admission, before removing feeding tube and within the first week following oral feeding resumption. Results: 48.51% patients could regain oral intake within 14 days from admission. Compared to admission and tube feeding phase, the level of prealbumin (mg/L) after oral feeding was significantly higher. (19.26±5.32. vs 22.57±5.03; P<0.001) (20.68±5.10 v 22.57±5.03; P=0.003). Based on prealbumin 20 mg/dL, 58.21 % of patients demonstrated poor nutrition at admission and 34.33 % after oral feeding resumption. BUN/Cr > 20:1 identified deficient hydration in 53.72 % of patients in tube feeding phase and 46.27 % of patients after oral intake. Differences in nutrition and hydration status were attributed to complete oral feeding resumption. Conclusion: Clinical practice of complete oral feeding resumption including evaluating swallow function of varying viscosities, dietary and fluid recommendations could achieve better nutrition and hydration status.