title: Factors Predicting Recovery of Oral Intake in Stroke Survivors with Dysphagia in a Convalescent Rehabilitation Ward.
abstract: BACKGROUND
  Percutaneous endoscopic gastrostomy may be performed in dysphagic stroke patients. However, some patients regain complete oral intake without gastrostomy. This study aimed to investigate the predictive factors of intake, thereby determining gastrostomy indications.
  
  
  METHODS
  Stroke survivors admitted to our convalescent rehabilitation ward who underwent gastrostomy or nasogastric tube placement from 2009 to 2015 were divided into 2 groups based on intake status at discharge. Demographic data and Functional Independence Measure (FIM), Dysphagia Severity Scale (DSS), National Institutes of Health Stroke Scale, and Glasgow Coma Scale (GCS) scores on admission were compared between groups. We evaluated the factors predicting intake using a stepwise logistic regression analysis.
  
  
  RESULTS
  Thirty-four patients recovered intake, whereas 38 achieved incomplete intake. Mean age was lower, mean body mass index (BMI) was higher, and mean time from stroke onset to admission was shorter in the complete intake group. The complete intake group had less impairment in terms of GCS, FIM, and DSS scores. In the stepwise logistic regression analysis, BMI, FIM-cognitive score, and DSS score were significant independent factors predicting intake. The formula of BMI × .26 + FIM cognitive score × .19 + DSS score × 1.60 predicted recovery of complete intake with a sensitivity of 88.2% and a specificity of 84.2%.
  
  
  CONCLUSIONS
  Stroke survivors with dysphagia with a high BMI and FIM-cognitive and DSS scores tended to recover oral intake.
authors.affiliation: Department of Rehabilitation Medicine, Yawata Medical Center, Komatsu City, Japan. Electronic address: Ikenaga@katsuki-g.com.
authors.forename: Yasunori
authors.initials: Y
authors.lastname: Ikenaga
authors.affiliation: Department of Rehabilitation Medicine, Yawata Medical Center, Komatsu City, Japan.
authors.forename: Sayaka
authors.initials: S
authors.lastname: Nakayama
authors.affiliation: Department of Rehabilitation Medicine, Yawata Medical Center, Komatsu City, Japan.
authors.forename: Hiroki
authors.initials: H
authors.lastname: Taniguchi
authors.affiliation: Department of Rehabilitation Medicine, Yawata Medical Center, Komatsu City, Japan.
authors.forename: Isao
authors.initials: I
authors.lastname: Ohori
authors.affiliation: Department of Rehabilitation Medicine, Yawata Medical Center, Komatsu City, Japan.
authors.forename: Nahoko
authors.initials: N
authors.lastname: Komatsu
authors.affiliation: Department of Rehabilitation Medicine, Yawata Medical Center, Komatsu City, Japan.
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Nishimura
authors.affiliation: Department of Rehabilitation Medicine, Yawata Medical Center, Komatsu City, Japan.
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Katsuki
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D016009:Chi-Square Distribution; D003071:Cognition; D003661:Decision Support Techniques; D003679:Deglutition; D003680:Deglutition Disorders / Q000209:etiology / Q000503:physiopathology / Q000523:psychology / Q000534:rehabilitation*; D004185:Disability Evaluation; D004435:Eating; D004947:Esophagus / Q000503:physiopathology*; D005260:Female; D005774:Gastrostomy; D015600:Glasgow Coma Scale; D006801:Humans; D007441:Intubation, Gastrointestinal; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D020127:Recovery of Function; D012189:Retrospective Studies; D012307:Risk Factors; D020521:Stroke / Q000150:complications / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D000071939:Stroke Rehabilitation / Q000379:methods*; D013997:Time Factors; D016896:Treatment Outcome
keywords: Dysphagia; complete oral intake; nasogastric tube feeding; percutaneous endoscopic gastrostomy; stroke