Nutrition support (tube feeding) as a rehabilitation intervention.
James R, Gines D, Menlove A, Horn SD, Gassaway J, Smout RJ. Nutrition support (tube feeding) as a rehabilitation intervention.


OBJECTIVE
To describe site variation in use of enteral feeding and its association with stroke rehabilitation outcomes, controlling for a variety of confounding variables.


METHODS
Prospective observational cohort study.


METHODS
Six inpatient rehabilitation facilities in the United States.


METHODS
Patients (N=919) from the Post-Stroke Rehabilitation Outcomes Project database with moderate or severe stroke who were discharged to home, community, or skilled nursing facility.


METHODS
Not applicable.


METHODS
Change in total, motor, and cognitive FIM instrument scores and change in severity of illness.


RESULTS
Monitoring of nutritional status and the frequency of tube-feeding interventions for patients with moderate and severe stroke varied significantly among sites. Patients with tube feeding had higher severity of illness and lower functioning on admission compared with patients who did not receive tube feeding. However, when we controlled for severity of illness, admission FIM score, and other important covariates, we found that patients with severe strokes who were tube fed for more than 25% of their stay had greater increases in total, motor, and cognitive FIM scores and greater improvement in severity of illness by discharge.


CONCLUSIONS
Nutrition support (tube feeding) is an effective therapy in rehabilitation service for patients with severe strokes and is associated with greater motor and cognitive improvements, even in patients with the most severe strokes.
James
Roberta
R
Institute for Clinical Outcomes Research, International Severity Information Systems Inc, Salt Lake City, UT 84102-1282, USA.
Gines
Deon
D
Menlove
Angela
A
Horn
Susan D
SD
Gassaway
Julie
J
Smout
Randall J
RJ
D000203:Activities of Daily Living; D000368:Aged; D004750:Enteral Nutrition / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D011446:Prospective Studies; D012047:Rehabilitation Centers; D012720:Severity of Illness Index; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome