Predictors of returning to oral feedings after feeding tube placement for patients poststroke during inpatient rehabilitation

Abstract

Objectives: To identify the frequency and characteristics of patients admitted to inpatient rehabilitation (IPR) following a stroke who are able return to oral feedings and have their feeding tube (FT) removed prior to discharge from IPR, the timing of FT removal, and implications for outcomes.

Methods: Medical records were identified by admission rehabilitation impairment code (RIC) for stroke (RIC 01), and reviews were completed by two physiatrists and two speech language pathologists. At random, 25% of the charts were reviewed by a second rater for data quality control. Measures collected during the chart review included the following: age, gender, onset of stroke, rehabilitation length of stay (LOS), admission and discharge FIM, discharge destination, diet level, and feeding tube status.

Results: One hundred forty-three patients were identified as subjects for this investigation who had an FT and were NPO upon IPR admission. Overall, 46.9% (67/143) of the patients returned to three meals daily prior to discharge from IPR. The mean days post stroke onset until returning to three meals daily was 38.43 days (SD=26.36). Twenty percent (30/143) of the patients were able to have their FT tube removed prior to discharge from IPR. Factors associated with returning to three meals included gender (ie, female), longer IPR LOS, and higher admission FIM scores at IPR. Factors associated with removal of the feeding tube included a longer IPR LOS and younger age. Patients who were able to have their FT removed were more likely to be discharged to home.

Conclusion: Individuals with longer IPR LOS were more likely to return to three meals daily and have their feeding tubes removed prior to discharge.