Predictive Factors for Oral Intake Recovery After Acute Stroke: Analysis of a Japanese Nationwide Inpatient Database
Predictive Factors for Oral Intake Recovery After Acute Stroke: Analysis of a Japanese Nationwide Inpatient Database
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DOI：
10.1007/s00455-022-10423-7
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发表时间：
2022-02-26
期刊：
影响因子：
2.6
通讯作者：
Haga, Nobuhiko
中科院分区：
文献类型：
--
作者：
Inooka, Yasuhiro;Yamana, Hayato;Haga, Nobuhiko
目的目前尚不清楚哪些因素有助于急性脑卒中后吞咽障碍的恢复。本研究旨在确定卒中后吞咽困难患者完全口服摄入恢复的相关因素。方法数据来自诊断程序组合数据库，这是一个日本全国性的行政索赔和出院摘要数据库。我们选择了中风发作3天内入院的患者，并进行了多因素logistic回归分析。入院后30天内的总口服摄入量是主要的结局指标。结果共纳入151，302例患者，其中48%的患者在入院30天内观察到总口服摄入量。总口服摄入量与年龄、性别、卒中亚型、意识障碍、低体重指数、多种合并症和卒中发作前改良兰金量表显著相关。此外，男性的预后比女性差（比值比，0.75; 95%置信区间，0.73-0.77，p < 0.001），脑内和蛛网膜下腔出血性卒中亚型与未恢复相关。结论本研究确定了急性脑卒中患者总口服摄入量的几个预后因素。这些结果可能有助于在入院时预测患者的吞咽困难预后，并为急性卒中患者设计营养管理计划。
Objective It remains unclear which factors contribute to dysphagia recovery after an acute stroke. This study aimed to identify factors associated with complete oral intake recovery in patients with post-stroke dysphagia. Methods Data were obtained from the Diagnosis Procedure Combination database, which is a nationwide database of administrative claims and discharge abstracts in Japan. We selected patients admitted within 3 days of stroke onset and conducted multivariable logistic regression analysis. Total oral intake within 30 days of admission was the primary outcome measure. Results A total of 151,302 patients were included, and total oral intake was observed in 48% of them within 30 days of admission. Total oral intake was significantly associated with age, sex, stroke subtype, consciousness disturbance, low body mass index, multiple comorbidities, and the modified Rankin Scale before stroke onset. In addition, males had worse outcomes than females (odds ratio, 0.75; 95% confidence interval, 0.73-0.77, p < 0.001), and intracerebral and subarachnoid hemorrhagic stroke subtypes were associated with non-recovery. Conclusion This study identified several prognostic factors for total oral intake in patients with acute stroke. These results may be useful for predicting a patient's dysphagia prognosis at the time of admission and designing a nutritional management plan for patients with acute stroke.