Factors Influencing Oral Intake Restoration at Discharge in Patients Undergoing Fasting During Acute Care Hospitalisation

IF 4 3区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of oral rehabilitation Pub Date : 2025-11-21 DOI:10.1111/joor.70107

Kohei Yoshikawa, Jun Kayashita, Takao Hamamoto, Masahiro Nakamori, Yukio Mikami, Sachio Takeno

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引用次数: 0

Abstract

Background

Dysphagia in older inpatients prolongs hospitalisation and increases pneumonia-related medical costs. In acute care hospitals, the prompt evaluation of oral intake potential is essential.

Objective

Early identification of patients with difficulty resuming oral intake and appropriate interventions, including alternative nutritional support, is crucial for preventing malnutrition and promoting functional recovery. This study aimed to identify the predictors of oral intake resumption at discharge in older inpatients by assessing swallowing function using the videoendoscopic Hyodo score and nutritional status using the Mini Nutritional Assessment–Short Form (MNA-SF) score.

Methods

This retrospective study included 114 older patients (mean age 77.9 ± 7.0 years) with a Functional Oral Intake Scale (FOIS) of 1 who underwent videoendoscopic evaluation between April 2020 and March 2022. Patients were classified into an oral intake group (FOIS ≥ 4 at discharge) or a non-oral intake group (FOIS < 4). Demographic, clinical, nutritional and swallowing-related variables were compared. Logistic regression was used to identify independent predictors, and receiver operating characteristic (ROC) analysis was used to assess predictive performance.

Results

In the logistic regression analysis, the MNA-SF score (odds ratio [OR] = 1.29, p = 0.003) and Hyodo score (OR = 0.84, p = 0.049) were independent predictors. Combined Hyodo and MNA-SF score, ROC analysis showed a sensitivity of 0.81, specificity of 0.61, and an area under the curve of 0.75 (95% confidence interval, 0.65–0.82).

Conclusion

Hyodo and MNA-SF scores can predict oral intake recovery at discharge in older inpatients, and a predictive model combining both is useful.

查看原文本刊更多论文

影响急性护理住院期间禁食患者出院时口腔摄入恢复的因素。

背景：老年住院患者吞咽困难延长住院时间并增加肺炎相关医疗费用。在急症护理医院，及时评估口服摄入潜力是必不可少的。目的：早期识别恢复口服进食困难的患者并采取适当的干预措施，包括替代营养支持，对于预防营养不良和促进功能恢复至关重要。本研究旨在通过视频内镜下Hyodo评分评估吞咽功能和Mini营养评估-简短形式（MNA-SF）评分评估营养状况，确定老年住院患者出院时口服摄入恢复的预测因素。方法：本回顾性研究纳入114例老年患者（平均年龄77.9±7.0岁），功能性口服摄入量表（FOIS）为1，于2020年4月至2022年3月期间接受了内镜检查。将患者分为口服摄入组（出院时FOIS≥4）和非口服摄入组(FOIS结果：logistic回归分析中，MNA-SF评分（优势比[or] = 1.29, p = 0.003）和Hyodo评分（or = 0.84, p = 0.049）为独立预测因子。综合Hyodo评分和MNA-SF评分，ROC分析显示敏感性为0.81，特异性为0.61，曲线下面积为0.75（95%可信区间为0.65 ~ 0.82）。结论：Hyodo评分和MNA-SF评分可以预测老年住院患者出院时的口服摄入恢复情况，两者结合的预测模型是有用的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of oral rehabilitation 医学-牙科与口腔外科

CiteScore

5.60

自引率

10.30%

发文量

116

审稿时长

4-8 weeks

期刊介绍： Journal of Oral Rehabilitation aims to be the most prestigious journal of dental research within all aspects of oral rehabilitation and applied oral physiology. It covers all diagnostic and clinical management aspects necessary to re-establish a subjective and objective harmonious oral function. Oral rehabilitation may become necessary as a result of developmental or acquired disturbances in the orofacial region, orofacial traumas, or a variety of dental and oral diseases (primarily dental caries and periodontal diseases) and orofacial pain conditions. As such, oral rehabilitation in the twenty-first century is a matter of skilful diagnosis and minimal, appropriate intervention, the nature of which is intimately linked to a profound knowledge of oral physiology, oral biology, and dental and oral pathology. The scientific content of the journal therefore strives to reflect the best of evidence-based clinical dentistry. Modern clinical management should be based on solid scientific evidence gathered about diagnostic procedures and the properties and efficacy of the chosen intervention (e.g. material science, biological, toxicological, pharmacological or psychological aspects). The content of the journal also reflects documentation of the possible side-effects of rehabilitation, and includes prognostic perspectives of the treatment modalities chosen.