急性期脳血管障害患者における嚥下障害の予後予測

概要

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Purpose: Stroke is a major etiological factor in dysphagia. The purpose of this study was to investigate the factors affecting difficulty of oral intake in patients with acute cerebrovascular disorder. Subjects: We recruited the stroke patients with suspected stroke-related dysphagia who were referred to speech, language, and hearing therapists at the emergency hospital for a swallowing examination between March 2009 and March 2010. Method: Multivariate analyses were performed to identify variables significantly associated with thepossibility of oral intake. Results: The mean age of the patients was 76.8 (SD12.7) years. A total of 158 patients suffered from ischemic stroke while 56 suffered from hemorrhagic stroke. At the point of discharge from the hospital, 107 patients (50.0%) resumed a regular diet. Logistic regression analysis identified 12 factors that significantly predicted the resumption of normal oral intakes. Conclusions: Normal or slight disturbance of consciousness (Japan Coma Scale: 0 or I-1), a food test profile score of 4 or above, normal swallowing sound on cervical auscultation, and a score > 0 on the Barthel Index were predictors of oral intake in patients with acute stage of cerebrovascular disorder.