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Rehabilitation Practice and Science

Translated Title

老年首次急性梗塞性腦中風後進食功能之恢復情形

Abstract

Introduction and Objective: The effects of aging on swallowing are particularly evident in elderly adults who are ill. Previous studies have reported that prolonged nasogastric tube (NGT) feeding in patients who have had a stroke increases the risk of pneumonia and mortality. However, few studies have investigated the recovery of oral intake function and the factors regarding NGT removal in patients with poststroke dysphagia. In the present study, we investigated the differences in oral intake function between elderly (age: ≥65 y) and nonelderly patients with first-ever acute ischemic stroke. Methods: In this retrospective study, we reviewarticleed the medical charts of patients with first-ever acute ischemic stroke between March and December 2012 at a medical center in southern Taiwan. The patients' demographic and clinical characteristics, including age, sex, stroke risk factors, National Institutes of Health Stroke Scale (NIHSS) score, and functional oral intake scale (FOIS) score were obtained. We used the independent t test, chi-square test, and Mann-Whitney test to compare the groups. Results: Sixty-six of the 97 enrolled patients were assigned to the elderly group and the remaining 31 were assigned to the nonelderly group (mean age: 77.12±6.88y vs 54.16±8.81 y). On initial evaluation, the elderly group exhibited a lower average FOIS score (3.48±2.12 vs 4.00±2.16), more frequent NGT insertions (53.0% vs 38.7%), and a higher incidence of aphasia (22.7% vs 16.1%); however, the difference between the 2 groups was nonsignificant. In addition, the initial NIHSS scores did not different significantly between the 2 groups. At discharge, the elderly group exhibited a significantly lower FOIS score (4.44±2.02 vs 5.45±1.86; p＜.05), significantly more frequent NGT insertion (40.9% vs 16.1%; p＜.05), and a significantly lower NGT removal rate (22.9% vs 58.3%; p＜.05). Moreover, the nonelderly group exhibited larger FOIS score changes, and was more likely to fully recover their oral intake function, although the difference between the groups was nonsignificant. Conclusions: This retrospective study revealed that when people with first-ever stroke had similar degrees of neurological impairment, those who were elderly had more severe poststroke dysphagia and poorer swallowing function recovery compared with those who were not elderly.

Language

Traditional Chinese

First Page

33

Last Page

40

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