Relationship between oral function in older patients with stroke and discharge to home from a convalescent rehabilitation ward

Abstract

Objective: The purpose of this study is to clarify how oral function affects the outcome of stroke patients aged 80 years or older admitted to a convalescent rehabilitation ward.

Subjects and methods: In this case-control study, 241 stroke patients aged 80 years or older who were admitted to a convalescent rehabilitation ward were divided by discharge destination into a home group (160 patients) and a facility group (81 patients). Their basic attributes, medical attributes functional independence evaluated by the Functional Independence Measure (FIM) at admission and discharge, and oral function assessed by the Revised Oral Assessment Guide (ROAG) were retrospectively investigated. Also, factors affecting discharge destination and cutoff values were examined.

Results: ROAG scores at admission were significantly lower, and FIM scores for motor and cognitive items at admission, total FIM scores and FIM scores for motor and cognitive items at discharge were significantly higher in the home group. Multiple logistic regression analysis revealed that the ROAG total score at admission (odds ratio 1.19, 95% confidence interval: 1.09–1.24) and FIM scores for motor items at discharge (odds ratio 0.96, 95% confidence interval: 0.93–0.99) were identified as factors influencing discharge to home. The cut-off values of discharge to home were a ROAG total score at admission of ≤13 points, and an FIM motor item score of ≥30.1 points).

Conclusions: Oral function at admission may contribute to identifying older stroke patients who are expected to have difficulty being discharged home to setting goals for them in a convalescent rehabilitation ward.