Percutaneous Endoscopic Gastrostomy Reduces Aspiration Pneumonia Rate in Stroke Patients with Enteral Feeding in Convalescent Rehabilitation Wards

Ikenaga, Yasunori; Kusunoki, Tadayuki; Yamaguchi, Hiromi

doi:10.2490/prm.20210031

Cited by 8 publications

(4 citation statements)

References 48 publications

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“…However, if patients are predicted to continue ICOI, they should undergo PEG to avoid aspiration pneumonia and self-removal of the NGT in the CRW. 27 ) The formula for the prediction of achieving COI has been reported in previous studies. 20 , 26 , 44 , 62 )…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, in this study, we used the large database of the Kaga Regional Cooperation Clinical Pathway for Stroke (KRCCPS) featuring data collected over a prolonged period from multiple centers, 27 , 28 , 29 , 30 ) including 19 acute care hospitals and 11 hospitals with CRWs. The aim of this study was to investigate factors contributing to COI at the time of discharge from CRWs for stroke patients with enteral feeding tubes in the local clinical setting.…”

Section: Introductionmentioning

confidence: 99%

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Factors Contributing to Complete Oral Intake in Dysphagic Stroke Patients with Enteral Feeding Tubes in Convalescent Rehabilitation Wards

Ikenaga

Fudeya²,

Kusunoki³

et al. 2023

PRM

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Objectives: This study investigated the factors contributing to complete oral intake (COI) in dysphagic stroke patients with enteral feeding tubes in the local clinical setting. Methods: Data of patients with percutaneous endoscopic gastrostomy (PEG) or nasogastric tube (NGT) feeding on admission to convalescent rehabilitation wards (CRWs) were extracted from the Kaga Regional Cooperation Clinical Pathway for Stroke database for multiple centers including 19 acute care hospitals and 11 hospitals with CRWs. Patients were divided into two groups based on their status regarding COI or incomplete oral intake (ICOI) at discharge. Logistic regression analysis with forced-entry variables was used to identify factors contributing to COI. Results: On discharge from CRWs, COI and ICOI were observed in 140 and 207 cases, respectively. The COI group was younger, had a higher rate of initial stroke, higher Functional Oral Intake Scale (FOIS) scores, higher Functional Independence Measure (FIM) motor and cognitive scores, higher Body Mass Index (BMI), lower rate of patients with PEG, and shorter stays in acute care wards. Logistic regression analysis with forced entry revealed that younger age; initial stroke; higher FOIS score, FIM cognitive score, and BMI; and shorter stay in the acute care ward contributed to COI. Conclusions: The primary factors contributing to COI in dysphagic stroke patients with enteral feeding tubes were younger age, initial stroke, higher swallowing and cognitive function, good nutritional status, and shorter stay in the acute care ward.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Factors Contributing to Complete Oral Intake in Dysphagic Stroke Patients with Enteral Feeding Tubes in Convalescent Rehabilitation Wards

Ikenaga

Fudeya²,

Kusunoki³

et al. 2023

PRM

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“…Healthcare professionals in acute-care and rehabilitation hospitals shared patients' information from the KRCCPS database. 17 The ward nurses described treatment process and current status regarding LUTS, methods of voiding management, rehabilitation and nursing care for voiding behavior, and additional urological examination and treatments along with the treatment process of the stroke. At the convalescent ward, the primary team comprising a physician incharge, a nurse, therapists, and a pharmacist developed a plan to improve voiding behavior.…”

Section: Continuous Care In the Convalescent Phasementioning

confidence: 99%

Association of a continuous continence self‐management program with independence in voiding behavior among stroke patients: A retrospective cohort study

Shogenji

Yoshida

Sumiya

et al. 2022

Neurourology and Urodynamics

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Aims: Many stroke patients cannot urinate independently due to motor and cognitive dysfunctions. This study examined whether a continuous continence self-management program during acute and convalescent phases is associated with independence in voiding behavior.Methods: A retrospective cohort study was conducted among stroke patients registered in the Council of Kaga Local Stroke Network, Japan, from 2015 to 2019. In the intervention group (n = 941), a multidisciplinary continence care team and ward nurses provided continence care in the acute phase and shared the information with the staff in the convalescent ward. The control group (n = 579) received traditional voiding care from ward nurses. The primary and secondary outcomes were independence in voiding behavior at discharge from the convalescent ward and length of hospital stay, respectively.Results: At discharge from the convalescent wards, the proportion of patients who voided at the toilet or bedside commode was higher in the intervention group than in the control group (76.3% vs. 62.4%, p < 0.001). The continuous continence self-management program was associated with independence in voiding behavior (adjusted odds ratio: 1.801, 95% confidence interval [CI]:[1.102, 2.942]; p = 0.019) and length of hospital stay (β: −0.178, 95% CI: [−14.320, −7.607]; p < 0.001) after adjusting for other variables. Conclusions: The program was associated with increasing independent voiding behavior and shortened the length of hospital stay, suggesting the importance of promoting treatments for lower urinary tract symptoms and rehabilitation by a multidisciplinary continence care team for stroke patients.

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“…This database covers 18 acute care hospitals, 11 hospitals with convalescent rehabilitation wards, and 476 facilities for community rehabilitation. 26) Data were stored in an Excel sheet by individuals involved in the care of stroke patients, such as physicians, nurses, physical therapists, occupational therapists, and pharmacists. The system has been operational since 2009 and has accumulated data for over 5000 individuals.…”

Section: Databasementioning

confidence: 99%

Relationship between Bowel/Bladder Function and Discharge in Older Stroke Patients in Convalescent Rehabilitation Wards: A Retrospective Cohort Study

Shogenji

Yoshida

Sumiya

et al. 2022

PRM

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Many stroke patients experience motor and cognitive dysfunctions that make living at home challenging. We aimed to identify the factors associated with hospital discharge to home in older stroke patients in convalescent rehabilitation wards where intensive and comprehensive inpatient rehabilitation are performed following acute-phase treatment. Methods: A retrospective cohort study was conducted among 1227 older stroke patients registered in the database of the Council of Kaga Local Stroke Network, Japan, between 2015 and 2019. Patients' basic characteristics, discharge destination, type and severity of stroke, cognitive status, and activities of daily living (ADL) including continence were evaluated. Results: The proportion of subjects discharged to home was 62.3%. The mean hospital stay in the home discharge group was shorter than that in the non-home discharge group (111 days vs. 144.6 days, P <0.001). The following factors were associated with discharge to home: age (adjusted odds ratio [AOR]: 2.801, 95% confidence interval [CI] [1.473, 2.940]; P <0.001), sex (AOR: 1.513, 95% CI [1.112, 2.059]), stroke type (AOR: 1.426, 95% CI [1.013, 2.007]), low cognitive status (AOR: 3.750, 95% CI [2.615, 5.379]), low level of bladder control (AOR: 2.056, 95% CI [1.223, 3.454]), and low level of bowel control (AOR: 2.823, 95% CI [1.688, 4.722]). Conclusions: Age, sex, stroke type, cognitive function, and ADL scores for bladder and bowel control were associated with discharge to home. Improving continence management regarding both voiding and defecation may be a promising care strategy to promote hospital discharge to home in older stroke patients.

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Percutaneous Endoscopic Gastrostomy Reduces Aspiration Pneumonia Rate in Stroke Patients with Enteral Feeding in Convalescent Rehabilitation Wards

Cited by 8 publications

References 48 publications

Factors Contributing to Complete Oral Intake in Dysphagic Stroke Patients with Enteral Feeding Tubes in Convalescent Rehabilitation Wards

Factors Contributing to Complete Oral Intake in Dysphagic Stroke Patients with Enteral Feeding Tubes in Convalescent Rehabilitation Wards

Association of a continuous continence self‐management program with independence in voiding behavior among stroke patients: A retrospective cohort study

Relationship between Bowel/Bladder Function and Discharge in Older Stroke Patients in Convalescent Rehabilitation Wards: A Retrospective Cohort Study

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