Acquisition of oral intake in severely dysphagic patients with acute stroke: a single-center, observational study involving a database of 4972 consecutive stroke patients.

OBJECTIVE: A single-center, observational study was performed to identify the predictors for oral intake 3 months after onset in stroke patients with severe dysphagia.

METHODS: Of 4972 consecutive acute stroke patients, 723 could not eat orally on day 10. Three months after onset, a questionnaire was sent to all patients. Those who survived and replied to the questionnaire were divided into 2 groups, and the clinical factors that predicted their acquisition of oral intake were analyzed.

RESULTS: Of the 586 dysphagic patients who responded, 141 (24.2%) achieved oral intake after 3 months. On logistic-regression model analysis, age ≤ 80 years, hyperlipidemia, non-cardioembolic stroke, modified Rankin Scale score 0 before onset, and National Institutes of Health Stroke Scale (NIHSS) score were independently related to oral intake 3 months after onset. From two different model analyses, NIHSS score ≤ 17 on day 10 (OR 3.58, 95% CI, 2.35-5.54) was found to be a stronger predictor for oral intake than NIHSS score ≤ 17 on admission (OR 2.17, 95% CI, 1.40-3.39).

CONCLUSION: In severely dysphagic acute stroke patients, functional independence at baseline, younger age, absence of hyperlipidemia, non-cardioembolic stroke, and a milder NIHSS score on day 10 are useful predictors of the resumption of oral intake.