Factors affecting return to oral intake in inpatient rehabilitation after acquired brain injury

Abstract

Primary objective: To extend previous observations by investigating if differences exist in time to initiation or to recovery of total oral intake in patients with acquired brain injury assessed by either Facial-Oral Tract Therapy (F.O.T.T.®) or Fibreoptic Endoscopic Evaluation of Swallowing (FEES) and to investigate whether other factors influence these outcomes.Research design: Randomized controlled trial.Methods: One hundred and nineteen patients with dysphagia in inpatient neurorehabilitation were randomized. The main outcome was time to maximum on the Functional Oral Intake Scale.Results: There was no difference in time to initiation or recovery of total oral intake using F.O.T.T.® or FEES. Oral intake was initiated for 42% on admission and 92% at discharge; 2.5% of the patients were on total oral intake within 24 hours of admission and 37% at discharge. The likelihood of recovery to total oral intake before discharge was found to depend on age, Functional Independence Measure score, length of stay and number of dysphagia interventions.Conclusion: There was no significant difference in time to initiation and recovery of total oral intake before discharge, whether assessed by F.O.T.T.® or FEES, indicating that an instrumental assessment is unnecessary for standard evaluation. Age, functional independence and length of stay had a significant influence.