Megumi Hatakeyama, SLHT, Motomichi Shirahase, SLHT, Syogo Suzuki, SLHT, Kazuyoshi Morita, MD, Shinya Yamashita, MD
Jpn J Compr Rehabil Sci 14: 60-68, 2023
Objective: The objective of this study was to
determine the characteristics of patients who exhibited
changes in their food intake level (as determined by
the Food Intake Level Scale [FILS] score) while
hospitalized for long-term bedside care.
Methods: The subjects were 264 patients hospitalized
for long-term bedside care. The FILS was used to
assess the subjects' mode of food intake on the
admission and survey dates. The FILS score was used
to divide the patients into three stages: no oral intake,
combined oral intake and alternative nutrition, and
exclusively oral intake; the patients whose FILS stage
on the survey date was different from that on the
admission date were examined to determine whether
there were any characteristic tendencies with regard to
their age, sex, length of hospital stay, level of longterm
care needed, primary illness, and dysphagia
rehabilitation.
Results: Overall, 6.8%, 9.8%, and 4.5% of the subjects
showed improvement in the FILS stage, experienced
deterioration of the FILS stage, and transitioned to
exclusively oral intake, respectively. Further, 33.3% of
the improved-FILS stage group were in their ≥90s.
The results of the exact binomial test with the entire
study cohort as the population proportion showed that
there were significantly more females in the improved-
FILS group. In addition, 83.3% of those who improved
from no oral intake to exclusively oral intake had
cerebrovascular disease. No difference in the length of
hospital stay and level of long-term care needed was
observed in either the improved-FILS or deteriorated-
FILS group in comparison to their proportions in the
entire study cohort. In the entire study cohort, a greater
proportion of the subjects in the improved-FILS group
underwent indirect or direct swallowing training than
those in the deteriorated-FILS group; the improved-
FILS group had no subjects who were assigned to
watchful waiting.
Conclusion: Most patients who exhibited marked
positive changes in their mode of food intake were
females or patients with cerebrovascular disease.
However, no characteristic attributes were observed
among those whose FILS stage deteriorated.
Key words: long-term care beds, changes in mode of food intake (FILS), dysphagia rehabilitation