Masako Takayama, RD, MS, Shinta Nishioka, RD, Takatsugu Okamoto, MD, PhD, Maki Urushihara, RD, Yumiko Kiriya, RD, Keiko Shintani, RD, Hiromi Nakagomi, RD, Sumi Hijioka, RD, Misuzu Watanabe, RD, Hidekazu Sugawara, MD, PhD, Makoto Ishikawa, MD, PhD, Ichiro Miyai, MD, PhD, Shigeru Sonoda, MD, PhD
Jpn J Compr Rehabil Sci 9: 11-21, 2018
Objective: This study aimed to identify the current
situation of nutritional status and swallowing training
in stroke patients with dysphagia in Kaifukuki
(convalescent) rehabilitation wards (KRWs).
Methods: We performed a retrospective study in the
KRWs of 25 hospitals to investigate the swallowing
function and nutritional status of stroke patients who
had dysphagia at admission to the KRW. Nutritional
status was assessed using the Geriatric Nutritional
Risk Index (GNRI) and swallowing function was
assessed by Fujishima’s swallowing grade (swallowing
grade).
Results: A total of 440 subjects were analyzed.
Malnutrition (GNRI < 92) was found in 63.4% of the
subjects at admission, and the rate was reduced
significantly (p < 0.05) to 42.7% at discharge. Among
the 440 subjects, 94.1% underwent indirect swallowing
training while 80.9% underwent direct training. The
median swallowing grade improved significantly (p <
0.05) from 2 at admission to 7 at discharge. At discharge,
53.4% of the subjects achieved oral intake of three
meals.
Conclusion: This multicenter survey revealed the
outcome of oral intake and nutritional status in stroke
patients with dysphagia in KRWs. These data are
expected to be utilized as benchmarks for the goal of
further improvement of the quality of nutritional care
and dysphagia rehabilitation in the future.
Key words: Kaifukuki rehabilitation ward, stroke, dysphagia, nutritional status, GNRI