Comparison of nasogastric tube and intermittent oro-esophageal tube feeding in patients with dysphagia and evaluation of an assessment scale for initial nutritional support selection.

OBJECTIVE

The aim of this study was to assess the clinical outcomes of nasogastric tube (NGT) feeding and intermittent oro-esophageal tube (IOE) feeding in patients with moderate-to-severe dysphagia, and to evaluate the IOE assessment scale in guiding the initial selection of nutritional support strategies.

METHODS

A total of 208 patients with stroke complicated by moderate-to-severe dysphagia (Chinese version of the Volume and Viscosity Swallowing Test, VVST-CV ≥ moderate impairment) who were admitted to the Cerebrovascular Center of Taizhou People's Hospital Affiliated to Nanjing Medical University between February 2024 and April 2025 were enrolled. Among these patients, 148 met the indications for IOE according to the IOE assessment scale. Of these, 124 patients with a hospital stay of ≥ 28 days were allocated into two groups based on the results of the IOE assessment scale: the NGT group (n = 64, control group) and the IOE group (n = 60, study group). Improvements in swallowing function, changes in the feeding component of activities of daily living (ADL), nutritional status and fluid intake, comfort level, and the incidence of tube dislodgement and aspiration were compared between the two groups.

RESULTS

Improvement in swallowing function was significantly greater in the IOE group than in the NGT group (p < 0.01). The increase in ADL feeding scores was more pronounced in the IOE group. On day 28, mean serum albumin score were significantly higher in the IOE group than in the control group (p < 0.01). Total fluid intake from day 1 to day 28 was significantly higher in the IOE group (p < 0.01). Patients in the IOE group reported higher comfort levels, and the incidences of aspiration and tube dislodgement were significantly lower compared with the NGT group (p < 0.05).

CONCLUSION

The IOE assessment scale may help guide the selection of nutritional support strategies for patients with dysphagia. In this study, compared with NGT, IOE feeding was associated with a shorter recovery time of swallowing function, improved physical and psychological comfort, enhanced nutritional status, increased fluid intake, and reduced risks of aspiration and tube dislodgement.