The relationship between feeding modes and quality of life among patients with post-stroke dysphagia: an observational study.

BACKGROUND

Tube feeding is common in patients with post-stroke dysphagia. However, its influence on quality of life remains not fully clear. This study aimed to explore the relationship between feeding modes and quality of life in ischaemic stroke survivors with pharyngeal dysphagia.

METHODS

This multicentre observational study included ischaemic stroke survivors with pharyngeal dysphagia in the rehabilitation departments between Feb. 2022 and Jun. 2024. The Dysphagia Handicap Index was used to assess health-related quality of life at baseline and on Day 10. Potential confounding variables were collected using questionnaires, medical records, and self-reports. Propensity score matching was performed to enhance statistical comparability between Intermittent Oro-Oesophageal and Nasogastric tube users. Generalized estimating equations were used to explore time, between-group, and interaction effects (time*group) on the Dysphagia Handicap Index outcomes.

RESULTS

There were 1344 and 1090 participants using intermittent oro-oesophageal and nasogastric tubes, respectively. At baseline, the median and quartiles of the Dysphagia Handicap Index total score were [53.00 (47.00, 59.00)], which significantly declined to [39.00 (35.00, 45.00)] on day 10. 781 pairs were matched with no significant differences in all covariates. In the matched samples, time and interaction effects were significant in both the Dysphagia Handicap Index total scores and the three dimensions. The participants using intermittent oro-oesophageal tubes improved significantly more in overall, functional and emotional quality of life.

CONCLUSION

The quality of life improved as rehabilitation therapy progressed among ischaemic stroke survivors with dysphagia. Compared to nasogastric feeding, intermittent oro-oesophageal feeding was expected to have advantages in enhancing overall, functional and emotional quality of life.