2025 Volume 29 Issue 2 Pages 41-50
Objective: We investigated the effect of short-term intensive multidisciplinary swallowing rehabilitation for patients with cerebrovascular disease who underwent percutaneous endoscopic gastrostomy (PEG) and factors related to the availability of oral intake at discharge. The subjects were 71 patients with cerebrovascular disorders who underwent PEG at our hospital between April 1, 2020 and March 31, 2023, and who received short-term intensive multidisciplinary swallowing rehabilitation before and after surgery.
Methods: The content of the short-term intensive multidisciplinary swallowing rehabilitation was an endoscopic swallowing evaluation (VE) performed on the day of admission, and based on the results, direct and indirect swallowing training according to swallowing ability was performed before and after surgery in collaboration with a multidisciplinary team including doctors, nurses, speech-language pathologists, physiotherapists, occupational therapists, dental hygienists, and dietitians. The analysis method was to compare FILS between patients at the time of admission and discharge, and divide the results at the time of discharge into two groups. One was patients with FILS 4 or higher who could perform oral intake, and the other was patients with FILS 3 or lower who could not perform oral intake.
Results: FILS was significantly higher at discharge than at admission (Wilcoxon signed rank test, p＜0.001). Univariate analysis showed significant positive correlations between oral intake ability at discharge and five variables (higher FILS at admission, lower Hyodo score, higher FIM at admission, higher motor FIM at admission, and higher cognitive FIM at admission). Multivariate analysis showed that lower Hyodo score at admission (adjusted odds ratio 0.62, 95% confidence interval 0.47–0.82, p＜0.001) and higher FIM (adjusted odds ratio 1.08, 95% confidence interval 1.02–1.03, p＜0.001) were significant predictors of oral intake.
Conclusion: For patients admitted to hospital for PEG, it is recommended to assess swallowing function using VE and to perform swallowing rehabilitation by a multidisciplinary team before and after surgery.
