Factors for Oral Intake Recovery in Acute Illness Patients With Dysphagia: A Prospective Cohort Study

IF 2.1 Q2 MEDICINE, GENERAL & INTERNAL

Health Science Reports Pub Date : 2025-07-21 DOI:10.1002/hsr2.70944

Sho Nishiguchi, Nagisa Sugaya, Miyo Akiyama, Masahiko Inamori

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Abstract

Background and Aims

This study examined to identify predictive factors for oral intake recovery in patients with acute illness after discharge from an acute care hospital.

Methods

The prospective cohort study was conducted at an acute care hospital between January and December 2020. Among 3359 consecutive patients who required speech therapy rehabilitation after acute illness treatment, those with oral intake difficulty were selected. After discharge, patients were followed up at home care service, long-term care facility, or sub-acute hospital. Difficulty in oral intake was defined based on the dysphagia grade by speech-language pathologists and overall oral intake consumption. The primary outcome measure was the recovery of total oral intake 90 days after discharge. We analyzed the clinically relevant factors for oral intake recovery using a multivariate logistic regression model.

Results

Among 512 patients with severe dysphagia and insufficient oral intake upon discharge, 410 were ultimately included (response rate: 80.0%) from 106 facilities, comprising a home care service, a long-term care facility, and another hospital. The mean age was 83.2 years, with 52.9% of the patients being men. The median length of the hospital stay was 27 days. Overall, 195 (47.4%) patients survived, and 57 (13.9%) recovered their oral intake 90 days after discharge. In the multivariable analysis, the absence of nocturnal suctioning (adjusted odds ratio = 3.8, 95% confidence interval: 1.9–7.5, p < 0.001), communication ability (p = 0.021), and artificial hydration and nutrition (p = 0.001) were significant factors associated with oral intake recovery within 90 days after discharge.

Conclusion

The factors identified in this study may contribute to prognosis of patients who can recover their oral intake at discharge from acute care hospitals and to the implementation of appropriate discharge plans and artificial hydration and nutrition.

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急性吞咽困难患者口服摄入恢复的因素：一项前瞻性队列研究

背景与目的本研究旨在探讨急性疾病患者出院后口服摄入恢复的预测因素。方法前瞻性队列研究于2020年1月至12月在某急症护理医院进行。在连续3359例急性病治疗后需要言语治疗康复的患者中，选择有口腔摄入困难的患者。出院后分别在家庭护理机构、长期护理机构和亚急性医院进行随访。言语病理学家根据吞咽困难的等级和总体的口服摄入消耗量来定义口腔摄入困难。主要结局指标是出院后90天总口服摄入量的恢复。我们使用多变量logistic回归模型分析了影响口服摄入恢复的临床相关因素。结果在512例出院时严重吞咽困难和口服摄入不足的患者中，最终纳入了来自106家机构的410例患者（有效率：80.0%），这些机构包括家庭护理服务机构、长期护理机构和另一家医院。平均年龄83.2岁，男性占52.9%。住院时间中位数为27天。总体而言，195例（47.4%）患者存活，57例（13.9%）患者在出院后90天恢复口服摄入。在多变量分析中，无夜间吸痰（调整优势比为3.8,95%可信区间为1.9-7.5,p < 0.001）、沟通能力（p = 0.021）、人工补水和营养（p = 0.001）是影响出院后90天内口服摄入恢复的显著因素。结论本研究确定的因素可能有助于急症医院出院时恢复口服摄入的患者的预后，并有助于实施适当的出院计划和人工补水和营养。

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