Factors Associated with Prognosis of Eating and Swallowing Disability after Stroke: A Study from a Community-based Stroke Care System

Abstract

The long-term prognosis of eating and swallowing disability has not been fully clarified. As community-based stroke care systems have developed in Japan, these data have become available. We examined changes in nutritional intake using data acquired from a community-based stroke care system. There were 334 stroke patients who were discharged from our acute care hospital and transferred to rehabilitation hospitals with tube feeding. We examined the relationship between the initial bedside swallowing assessment and the method of nutrition delivery at discharge from a rehabilitation hospital. We also calculated the functional independent measure (FIM) to examine the relationship between activities of daily living and nutritional intake. There were 291 patients on oral intake and 43 on enteral feeding at discharge from a rehabilitation hospital. Patients with enteral feeding were older than patients with oral intake (69.4 ± 11.4 v 75.2 ± 9.9 years; P = .0016). The enteral feeding group also had lower FIM gain (27.5 ± 28.3 v 16.5 ± 23.5; P = .0161) and FIM efficiency (1.10 ± 1.24 v 0.65 ± 1.26; P = .0270) at the acute care hospital. Age, FIM gain, and FIM efficacy in the acute care hospital reliably predicted the long-term prognosis of eating and swallowing disability.