2021 Volume 25 Issue 1 Pages 22-32
Purpose: The aim of this study was to examine whether the improvement in the Food Intake LEVEL Scale (FILS) among inpatients using artificial nutrition is related to rehabilitation, nutritional management, hospital variety, etc. A secondary analysis of the stroke (convalescence phase) database of the Japan Rehabilitation Nutrition Database (2015), was used for factor analysis.
Methods: The subjects were 232 cases using artificial nutrition (average age 82.2±9.5 years) among the cases in the Japan Rehabilitation Nutrition Database (N＝1105). As a total of 19 independent variables, seven factors related to “disease” such as gender, age, and disease; six factors related to “nutrition/rehabilitation evaluation” such as FIM score, nutritional evaluation, and dysphagia rehabilitation; and six factors related to “hospital diversity” and “outcome” were set.
The relationship between the variable and the dependent variable “FILS difference at admission and discharge” (excluding patients with FILS Lv.7 or higher at admission) was analyzed by Spearman's rank correlation coefficient (ρ). In addition, the Mann-Whitney U test and Kruskal-Wallis test were used to analyze the “FILS difference at admission and discharge” of each independent variable by a nonparametric test (p＜0.01).
Results: The median age of this database was 83.0 (76.0‐89.0). A correlation analysis between the dependent variable “FILS difference at admission and discharge” and the variables of inpatients using artificial nutrition showed that “FILS at discharge” (ρ＝0.73) and “FIM at discharge” (ρ＝0.66) were correlated (p＜0.01).
The results of testing the difference between “FILS difference at admission and discharge” and each variable showed that the “disease” variable was significantly different in malnutrition (p＜0.01). In the “nutrition / rehabilitation evaluation” variable, there was a significant difference in MNA-SFC (p＜0.01). The “outcome” variable was significantly different only at the discharge destination (p＜0.01).
Conclusion: The results of this study show that “improvement of oral intake” in elderly inpatients using artificial nutrition is associated with ADL at discharge, nutritional assessment, rehabilitation, and discharge location. On the other hand, “improvement of oral intake” was not related to aging, severity of pneumonia, complications, and hospital variety.
