Associating Factors Regarding Nasogastric Tube Removal in Patients With Dysphagia After Stroke

Lee, Jong Hwa; Kim, Sang Beom; Lee, Kyeong Woo; Lee, Sook Jeong; Park, Jin Gee; Ri, Jae Won

doi:10.5535/arm.2014.38.1.6

Cited by 20 publications

(28 citation statements)

References 25 publications

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“…This study revealed that age, FOIS, and NHISS on admission may be the key individual factors that determine swallowing recovery at day 7, day 14, and day 30 for patients after acute stroke, similar to some previous studies. 30,31 The FOIS is a widely used, reliable and valid outcome parameter to measure a patient's safe and adequate functional oral intake, 24 ranging from 1 (nothing by mouth) to 7 (total oral diet with no restrictions). Galovic et al identified age, stroke sever-ity on admission, lesion location, initial risk of aspiration, and initial impairment of oral intake as variables for predicting the recovery of oral intake and a return to prestroke diet at day 7 and at day 30.…”

Section: Discussionmentioning

confidence: 99%

Nomogram for predicting swallowing recovery in patients after dysphagic stroke

Wang

Shi

Zhang

et al. 2021

J Parenter Enteral Nutr

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Background: To date, variables predicting the recovery of dysphagia in patients after dysphagic stroke have not been well defined. However, despite the difficulties in predicting and understanding the dysphagia recovery trajectory, its significance for stroke care cannot be understated. This study aims to identify the factors for functional swallowing recovery and develop nomograms that predict dysphagia recovery after stroke. Methods:The demographic, neurological, and swallowing characteristics were compared between patients who recovered from dysphagia and those who did not. Then, the factors with P <.1 through comparison were enrolled in the multivariable logistic regression analysis to build a prediction model. A nomogram was also built to provide a quantitative tool. Discrimination, calibration, and clinical usefulness of the prediction model were assessed by using the C index, calibration plot, and decision curve analysis.Results: Predictors in the early-phase (T7) prediction nomogram included age, Functional Oral Intake Scale (FOIS), National Institutes of Health Stroke Scale (NHISS), hemispheric stroke, and brainstem stroke on admission. In the middle phase (T14), predictors included age, FOIS, and NHISS on admission. In the late phase (T30), predictors included age, FOIS, NHISS, bilateral stroke, and body mass index on admission. The C index for the day 7, day 14, and day 30 prediction nomograms were 0.847 (95% CI, 0.804-0.884), 0.817 (95% CI, 0.772-0.857), and 0.786 (95% CI, 0.739-0.829). Conclusion:These novel nomograms predicting dysphagia recovery after ischemic stroke are discriminative and well calibrated and could be used to guide enteral nutrition decision making, rehabilitation plans, and individualized care.

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Section: Discussionmentioning

confidence: 99%

Nomogram for predicting swallowing recovery in patients after dysphagic stroke

Wang

Shi

Zhang

et al. 2021

J Parenter Enteral Nutr

View full text Add to dashboard Cite

show abstract

“…Instead, we used FIM, which is strongly correlated with severity at the onset of stroke, as a covariate. On the other hand, a retrospective study indicated that there was no difference in National Institute of Health Stroke Scale scores between the stroke region‐matched patients who achieved full oral intake and those who were dependent on tube feeding . Therefore, stroke region and the severity of stroke should be taken into account in the cohort study investigating prognosis of dysphagia.…”

Section: Discussionmentioning

confidence: 99%

Impact of nutritional status, muscle mass and oral status on recovery of full oral intake among stroke patients receiving enteral nutrition: A retrospective cohort study

Nishioka¹,

Yamasaki

Ogawa³

et al. 2019

Nutrition & Dietetics

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Aim: To clarify the correlation between malnutrition, muscle mass and oral status, and swallowing function recovery in stroke patients receiving enteral nutrition. Methods: Patients with stroke and dysphagia receiving any amount of enteral nutrition in rehabilitation wards from 2012 to 2016 were eligible for inclusion in this retrospective study. On admission, body composition by bioimpedance analysis, malnutrition confirmed by the European Society for Clinical Nutrition and Metabolism criteria, oral status, functional independence measure and demographic data were collected. Characteristics were compared between "oral intake alone" and "artificial nutrition" groups based on the discharge status. Kaplan-Meier methods and the Cox proportional hazards model were used to determine explanatory factors for the probability of full oral intake. Results: Among 174 patients, 113 were analysed (55 women; median age, 77 years). Overall, 61% and 39% were classified as "oral intake alone" and "artificial nutrition," respectively. Days from onset to admission to rehabilitation wards and motor Functional Independence Measure were higher in the "oral intake alone" group. Kaplan-Meier analysis demonstrated that patients with lower muscle mass exhibited lower probability of full oral intake (P = .009). The Cox proportional hazards model suggested that lower muscle mass (hazard ratio, 0.493; 95% CI, 0.286-0.850) and poor oral hygiene (hazard ratio, 0.573; 95% CI, 0.333-0.987) were independently correlated with "oral intake alone" status. Malnutrition and other oral status are not related to achieving full oral intake.

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“…The PAS offers the advantage that it takes relatively less time to interpret the scores than other methods and that it exhibits a high inter-rater reliability [ 12 ]. However, previous studies on the PAS were mostly based on nasogastric tube removal, and it was difficult to find a study of gastrostomy tube weaning based on the PAS score [ 13 , 14 ]. In this study, the PAS score was found to be an independent predictive factor, and the PAS was considered a screening test for successful gastrostomy tube weaning.…”

Section: Discussionmentioning

confidence: 99%

Clinical Factors Associated With Successful Gastrostomy Tube Weaning in Patients With Prolonged Dysphagia After Stroke

et al. 2021

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Objective To investigate the clinical factors associated with successful gastrostomy tube weaning in patients with prolonged dysphagia after stroke. Methods This study involved a retrospective medical chart review of patients diagnosed with prolonged dysphagia after stroke who underwent gastrostomy tube insertion between May 2013 and January 2020. Forty-seven patients were enrolled and consequently divided into gastrostomy tube sustaining and weaning groups. The numbers of patients in the sustaining and weaning groups were 31 and 16, respectively. The patients' demographic data, Korean version of Mini-Mental State Examination (K-MMSE) score, Korean version of the Modified Barthel Index (K-MBI), Functional Dysphagia Scale (FDS) score, and Penetration-Aspiration Scale (PAS) score were compared between the two groups. A videofluoroscopic swallowing study was performed before making the decision of gastrostomy tube weaning. The clinical factors associated with gastrostomy tube weaning were then investigated. Results There were significant differences in age; history of aspiration pneumonia; K-MMSE, FDS, and PAS scores; and K-MBI between the groups. In the multiple logistic regression analysis, the FDS (odds ratio [OR]=0.791; 95% confidence interval [CI], 0.634-0.987) and PAS scores (OR=0.205; 95% CI, 0.059-0.718) were associated with successful gastrostomy tube weaning. In the receiver operating characteristic curve analysis, the FDS and PAS were useful screening tools for successful weaning, with areas under the curve of 0.911 and 0.918, respectively. Conclusion In patients with prolonged dysphagia, the FDS and PAS scores are the only factors associated with successful gastrostomy tube weaning. An evaluation of the swallowing function is necessary before deciding to initiate gastrostomy tube weaning.

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Associating Factors Regarding Nasogastric Tube Removal in Patients With Dysphagia After Stroke

Cited by 20 publications

References 25 publications

Nomogram for predicting swallowing recovery in patients after dysphagic stroke

Nomogram for predicting swallowing recovery in patients after dysphagic stroke

Impact of nutritional status, muscle mass and oral status on recovery of full oral intake among stroke patients receiving enteral nutrition: A retrospective cohort study

Clinical Factors Associated With Successful Gastrostomy Tube Weaning in Patients With Prolonged Dysphagia After Stroke

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