Predictive Factors for Nasogastric Tube Removal in Post-Stroke Patients

Author:

Chuang Shu-Ting12,Yen Ya-Hui13ORCID,Hsu Honda45,Lai Ming-Wei567,Hung Yu-Fang1,Tsai Sen-Wei567

Affiliation:

1. Department of Nursing, Taichung Tzu Chi Hospital Buddhist Tzu Chi Medical Foundation, Taichung City 427213, Taiwan

2. Department of Nursing, Tzu Chi University of Science and Technology, Hualien 970046, Taiwan

3. Department of Nursing, National Chi Nan University, Puli Township 545301, Taiwan

4. Division of Plastic Surgery, Dalin Tzu Chi Hospital Buddhist Tzu Chi Medical Foundation, Chiayi City 622007, Taiwan

5. School of Medicine, Tzu Chi University, Hualien 970374, Taiwan

6. Department of Physical Medicine and Rehabilitation, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung City 427213, Taiwan

7. Department of Post-Acute Care Center, Taichung Tzu Chi Hospital Buddhist Tzu Chi Medical Foundation, Taichung City 427213, Taiwan

Abstract

Background and Objectives: Stroke patients have different levels of functional impairment, and rehabilitation is essential to achieving functional recovery. Many post-stroke patients transition from acute treatment to post-acute care (PAC) with nasogastric tubes (NGTs) for rehabilitation. However, long-term NGT placement can lead to several complications, and its earlier removal can effectively reduce the incidence of mortality. This study aimed to use a PAC–cerebrovascular disease (CVD) program and physical functional evaluation scale tools to demonstrate the factors associated with NGT removal before post-stroke patient discharge. Materials and Methods: In this retrospective cohort study, data were collected between January 2017 and August 2022. We divided patients who had NGTs at admission into discharged with and without NGT groups to compare their baseline characteristics and physical functional status. Logistic regression analysis was used to detect the predictive factors for NGT removal. Results: There were 63 participants: 22 without NGT removal and 41 with NGT removal. The NGT removal rate was 65%. Age and scores for the activities of daily living by the Barthel index (BI), Functional Oral Intake Scale (FOIS), Mini-Mental State Examination, and Concise Chinese Aphasia Test were significantly different in terms of NGT removal status, but only the BI and FOIS were significantly correlated with NGT removal. Patients’ BI scores indicating severe to moderate dependence (21–90) had a 4.55 times greater chance of NGT removal (odds ratio, 4.55; p < 0.05) than patients who had total dependence (<20). Every one-point increase in FOIS score indicated a 3.07 times greater chance of NGT removal (odds ratio, 3.07; p < 0.05). Conclusions: The BI and FOIS evaluations may indicate the probability of NGT removal in patients.

Funder

Taichung Tzu Chi Hospital

Publisher

MDPI AG

Subject

General Medicine

Reference29 articles.

1. (2022, March 21). Health Promotion Administration, MOHW, Available online: https://www.hpa.gov.tw/Pages/List.aspx?nodeid=213.

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3. The demonstration on improving the quality of post-acute care in Taiwan National Health Insurance;Han;New Taipei J. Nurs.,2015

4. Three years of the nationwide post-acute stroke care program in Taiwan;Hsieh;J. Chin. Med. Assoc.,2018

5. Intravascular laser irradiation of blood improves functional independence in subacute post-stroke patients: A retrospective observational study from a post-stroke acute care center in Taiwan;Lai;Photobiomodul. Photomed. Laser Surg.,2022

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