title: Acquisition of oral intake in severely dysphagic patients with acute stroke: a single-center, observational study involving a database of 4972 consecutive stroke patients.
abstract: OBJECTIVE
  A single-center, observational study was performed to identify the predictors for oral intake 3 months after onset in stroke patients with severe dysphagia.
  
  
  METHODS
  Of 4972 consecutive acute stroke patients, 723 could not eat orally on day 10. Three months after onset, a questionnaire was sent to all patients. Those who survived and replied to the questionnaire were divided into 2 groups, and the clinical factors that predicted their acquisition of oral intake were analyzed.
  
  
  RESULTS
  Of the 586 dysphagic patients who responded, 141 (24.2%) achieved oral intake after 3 months. On logistic-regression model analysis, age ≤ 80 years, hyperlipidemia, non-cardioembolic stroke, modified Rankin Scale score 0 before onset, and National Institutes of Health Stroke Scale (NIHSS) score were independently related to oral intake 3 months after onset. From two different model analyses, NIHSS score ≤ 17 on day 10 (OR 3.58, 95% CI, 2.35-5.54) was found to be a stronger predictor for oral intake than NIHSS score ≤ 17 on admission (OR 2.17, 95% CI, 1.40-3.39).
  
  
  CONCLUSIONS
  In severely dysphagic acute stroke patients, functional independence at baseline, younger age, absence of hyperlipidemia, non-cardioembolic stroke, and a milder NIHSS score on day 10 are useful predictors of the resumption of oral intake.
authors.affiliation: Department of Neurology, Stroke Center, Saiseikai Kumamoto Hospital, Kumamoto, Japan. nakazima04@gmail.com
authors.forename: Makoto
authors.initials: M
authors.lastname: Nakajima
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Inatomi
authors.forename: Toshiro
authors.initials: T
authors.lastname: Yonehara
authors.forename: Yoichiro
authors.initials: Y
authors.lastname: Hashimoto
authors.forename: Teruyuki
authors.initials: T
authors.lastname: Hirano
mesh_terms: D000208:Acute Disease; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000150:complications* / Q000453:epidemiology; D002318:Cardiovascular Diseases / Q000453:epidemiology; D015897:Comorbidity; D016208:Databases, Factual; D003680:Deglutition Disorders / Q000209:etiology* / Q000534:rehabilitation / Q000628:therapy; D003920:Diabetes Mellitus / Q000453:epidemiology; D004435:Eating; D004750:Enteral Nutrition; D005260:Female; D005500:Follow-Up Studies; D006782:Hospitals, Special / Q000706:statistics & numerical data; D006801:Humans; D006949:Hyperlipidemias / Q000453:epidemiology; D020766:Intracranial Embolism / Q000150:complications / Q000453:epidemiology; D007564:Japan / Q000453:epidemiology; D008297:Male; D008954:Models, Biological; D011379:Prognosis; D011788:Quality of Life; D020127:Recovery of Function; D012189:Retrospective Studies; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D017741:Survivors