title: Factors associated with prognosis of eating and swallowing disability after stroke: a study from a community-based stroke care system.
abstract: BACKGROUND
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  Age, FIM gain, and FIM efficacy in the acute care hospital reliably predicted the long-term prognosis of eating and swallowing disability.
authors.affiliation: Department of Rehabilitation Medicine II, School of Medicine, Fujita Health University, Mie, Japan. Electronic address: maeshima@fujita-hu.ac.jp.
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Maeshima
authors.forename: Aiko
authors.initials: A
authors.lastname: Osawa
authors.forename: Takeshi
authors.initials: T
authors.lastname: Hayashi
authors.forename: Norio
authors.initials: N
authors.lastname: Tanahashi
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D003680:Deglutition Disorders / Q000209:etiology* / Q000503:physiopathology / Q000534:rehabilitation; D004185:Disability Evaluation; D006233:Persons with Disabilities / Q000534:rehabilitation; D001068:Feeding and Eating Disorders / Q000209:etiology* / Q000503:physiopathology / Q000534:rehabilitation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D020127:Recovery of Function; D012047:Rehabilitation Centers; D012307:Risk Factors; D020521:Stroke / Q000150:complications* / Q000503:physiopathology; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome
keywords: Clinical pathway; dysphagia; regional network; stroke