Factors Influencing Oral Intake Restoration at Discharge in Patients Undergoing Fasting During Acute Care Hospitalisation.

BACKGROUND

Dysphagia in older inpatients prolongs hospitalisation and increases pneumonia-related medical costs. In acute care hospitals, the prompt evaluation of oral intake potential is essential.

OBJECTIVE

Early identification of patients with difficulty resuming oral intake and appropriate interventions, including alternative nutritional support, is crucial for preventing malnutrition and promoting functional recovery. This study aimed to identify the predictors of oral intake resumption at discharge in older inpatients by assessing swallowing function using the videoendoscopic Hyodo score and nutritional status using the Mini Nutritional Assessment-Short Form (MNA-SF) score.

METHODS

This retrospective study included 114 older patients (mean age 77.9 ± 7.0 years) with a Functional Oral Intake Scale (FOIS) of 1 who underwent videoendoscopic evaluation between April 2020 and March 2022. Patients were classified into an oral intake group (FOIS ≥ 4 at discharge) or a non-oral intake group (FOIS < 4). Demographic, clinical, nutritional and swallowing-related variables were compared. Logistic regression was used to identify independent predictors, and receiver operating characteristic (ROC) analysis was used to assess predictive performance.

RESULTS

In the logistic regression analysis, the MNA-SF score (odds ratio [OR] = 1.29, p = 0.003) and Hyodo score (OR = 0.84, p = 0.049) were independent predictors. Combined Hyodo and MNA-SF score, ROC analysis showed a sensitivity of 0.81, specificity of 0.61, and an area under the curve of 0.75 (95% confidence interval, 0.65-0.82).

CONCLUSION

Hyodo and MNA-SF scores can predict oral intake recovery at discharge in older inpatients, and a predictive model combining both is useful.