We reviewed the medical charts of 220 stroke patients who exhibited swallowing difficulty. We used videofluoroscopy (VF) to determine significant, predictive factors for the patients' successful resumption of a regular diet. Patients' mean age was 75 (SD 10), 154 had ischemic stroke; 66 had hemorrhagic stroke. Patients with subarachnoid hemorrhage were not included. After completion of an inpatient rehabilitation program, 173 patients (79%) resumed a regular diet. Forty-seven patients (21%) required tube feeding as their sole source of water and nutrition or as a supplement to oral intake. Mean length of hospital stay was 106 days (SD 62). Logistic regression analysis identified three significant factors in predicting the resumption of a regular diet: 1) aspiration as documented by the VF study (
p=0.007, OR 3.992, 95%Cl 1.45-10.96); 2) bilateral lesion confirmed by brain CT or MRI (
p=0.002, OR 3.124, 95%Cl 1.45-6.53); and 3) presence of severe hemiplegia (
p=0.003, OR 3.068, 95%Cl 1.45-6.48). Patients with at least 2 favorable values in 3 factors had a high possibility of resuming successful oral feeding. However, even with an unfavorable value in all 3 factors, 49% of patients resumed a regular diet. In conclusion, during the acute phase, we can predict with relatively high accuracy the resumption of regular diet for dysphagic stroke patients; however, it is difficult to predict which patients will not resume a regular diet without tube feeding.
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