Impact of nutritional status, muscle mass and oral status on recovery of full oral intake among stroke patients receiving enteral nutrition: A retrospective cohort study

Nishioka, Shinta; Yamasaki, Kazumi; Ogawa, Kenji; Oishi, Kana; Yano, Yumihiko; Okazaki, Yuka; Nakashima, Ryusei; Kurihara, Masaki

doi:10.1111/1747-0080.12579

Cited by 20 publications

(36 citation statements)

References 43 publications

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“…Hence, even in acute care settings, proper dysphagia rehabilitation must be started at an early stage after stabilisation of the patient's general condition 9 . Improvement of the oral status and function is important to conduct dysphagia rehabilitation safely 10 . However, inpatients with dysphagia, particularly elderly patients, have poor oral health and hygiene with a high prevalence of caries, periodontal disease and edentulous jaws 11 .…”

Section: Introductionmentioning

confidence: 99%

Food intake and oral health status of inpatients with dysphagia in acute care settings

Furuya

Suzuki

Tamada

et al. 2020

J of Oral Rehabilitation

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Oral feeding and swallowing functions tend to decline with age, and functional problems are exacerbated in older subjects with systemic disorders, including cerebrovascular disorders. 1 The reported prevalence of dysfunction involving oral feeding and swallowing is approximately 30% in community-dwelling elderly subjects 2 and 50% in institutionalised individuals. 3 Many patients admitted to acute care hospitals are affected by dysphagia due to the impact of various systemic disorders.Matsuo et al 4 reported that dysphagia affects more than 25% of inpatients in acute care hospitals. Dysphagia causes aspiration pneumonia, 5 malnutrition, dehydration 6,7 and dietary restrictions. Moreover, AbstractAdequate oral status and functional assessments are important for dysphagia rehabilitation in acute care inpatient settings, especially to establish individualised oral intake. However, the association between food intake levels and oral function has not been elucidated in acute care inpatients. This cross-sectional study clarified the association between oral intake levels and the oral status/function of patients with dysphagia admitted to acute care settings. Admitted patients aged ≥40 years (n = 459; men: 288; mean age: 70.8 ± 12.0) examined at the Department of Dysphagia Rehabilitation at the Iwate Medical University Hospital from April 2007 to March 2014 were included. The oral health status was evaluated by the tongue coating, oral dryness severity, plaque control, posterior occlusal support and a repetitive saliva swallowing test (RSST). Dysphagia severity was determined from the Dysphagia Severity Scale. Oral intake levels were evaluated using the Functional Oral Intake Scale (FOIS) at the time of the initial dental examination (FOIS-I), and they were reevaluated after the revision of levels according to the participants' general condition and oral health status (FOIS-R). Divergence between FOIS-I and FOIS-R was noted in >40% patients. Multiple regression analysis showed significant associations between FOIS-R and consciousness level, activities of daily living, tongue coating, RSST and posterior occlusal support. Patients with dysphagia in acute care settings require detailed assessments of their oral status and function, including swallowing, to determine the most suitable feeding methods and dental interventions to improve oral intake levels. K E Y W O R D S acute care, dentures, dysphagia, oral health, posterior occlusal support, swallowing | 737 FURUYA et Al.since eating is an enjoyable day-to-day experience, dysphagia causes deterioration in the quality of life (QOL). 8Early rehabilitation is effective in dysphagia management. Hence, even in acute care settings, proper dysphagia rehabilitation must be started at an early stage after stabilisation of the patient's general condition. 9 Improvement of the oral status and function is important to conduct dysphagia rehabilitation safely. 10 However, inpatients with dysphagia, particularly elderly patients, have poor oral health and hygiene with a high prevalence ...

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Section: Introductionmentioning

confidence: 99%

Food intake and oral health status of inpatients with dysphagia in acute care settings

Furuya

Suzuki

Tamada

et al. 2020

J of Oral Rehabilitation

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“…Thus, sarcopenia can be developed in cerebrovascular patients regardless of swallowing ability. As previous studies showed a relationship between decreased muscle mass, the onset of dysphagia and poor recovery of swallowing function [44,45], the association between dysphagia and sarcopenia would be strengthened in patients without cerebrovascular disease.…”

Section: Potentially Associated Factors Of the Co-msmentioning

confidence: 91%

Prevalence and Associated Factors of Coexistence of Malnutrition and Sarcopenia in Geriatric Rehabilitation

Nishioka¹,

Matsushita²,

Yamanouchi³

et al. 2021

Nutrients

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Malnutrition and sarcopenia often coexist in rehabilitation patients, although they are often overlooked and undertreated in clinical practice. This cross-sectional study aimed to clarify the prevalence of the coexistence of malnutrition and sarcopenia (Co-MS) and its associated factors in convalescent rehabilitation wards in Japan. Consecutive patients aged ≥ 65 years in convalescent rehabilitation wards between November 2018 and October 2020 were included. Malnutrition and sarcopenia were determined by the Global Leadership Initiative on Malnutrition (GLIM) criteria and the Asian Working Group for Sarcopenia (AWGS 2019) criteria, respectively. Patients who presented both with malnutrition and sarcopenia were classified as Co-MS. Potentially associated factors included age, sex, days from onset to admission of rehabilitation wards, reason for admission, pre-morbid functional dependency, comorbidity, activities of daily living, swallowing ability, and oral function and hygiene. The prevalence of malnutrition, sarcopenia, and Co-MS was calculated. Binary logistic regression analyses were performed to compute odds ratios (ORs) and the 95% confidence interval (CI) of possible associated factors for each condition. Overall, 601 patients were eligible for the analysis (median 80 years old, 355 female patients, 70% cerebrovascular disease). Co-MS, malnutrition, and sarcopenia were found in 23.5%, 29.0%, and 62.4% of the enrolled patients, respectively. After adjustment, onset–admission interval (OR = 1.04; 95%CI = 1.02 to 1.06), hospital-associated deconditioning (OR = 4.62; 95%CI = 1.13 to 18.8), and swallowing ability (Food Intake LEVEL Scale) (OR = 0.83; 95%CI = 0.73 to 0.93) were identified as independent explanatory factors of Co-MS. In conclusion, Co-MS was prevalent in geriatric rehabilitation patients; thus, healthcare professionals should be aware of the associated factors to detect the geriatric rehabilitation patients who are at risk of both malnutrition and sarcopenia, and to provide appropriate treatments.

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“…The risk of malnutrition in patients without dysphagia increases if long-term energy intake insufficiency is accompanied by insufficient protein intake, suggesting that monitoring nutritional intake is necessary. The loss of consciousness (29,30), poor oral hygiene (31), depression (32), reduced mobility (30), and limb and face weakness are associated with a high risk of malnutrition. During hospitalization, age, IS, National Institutes of Health Stroke Scale (NIHSS) score at admission, geriatric nutritional risk index (GNRI) at admission (33).…”

Section: Risk Factors Of Malnutrition In Stroke Patientsmentioning

confidence: 99%

Enteral nutrition management in stroke patients: a narrative review

Gong¹,

Wang²,

Shi³

2021

Ann Palliat Med

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Impact of nutritional status, muscle mass and oral status on recovery of full oral intake among stroke patients receiving enteral nutrition: A retrospective cohort study

Cited by 20 publications

References 43 publications

Food intake and oral health status of inpatients with dysphagia in acute care settings

Food intake and oral health status of inpatients with dysphagia in acute care settings

Prevalence and Associated Factors of Coexistence of Malnutrition and Sarcopenia in Geriatric Rehabilitation

Enteral nutrition management in stroke patients: a narrative review

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