A study of patients whose mode of food intake changed during long-term bedside care

Hatakeyama M, Shirahase M, Suzuki S, Morita K, Yamashita S. A study of patients whose mode of food intake changed during long-term bedside care. Jpn J Compr Rehabil Sci 2023; 14: 60-68.

The objective of this study was to determine the characteristics of patients who exhibited changes in their food intake level (as determined by the Food Intake Level Scale [FILS] score) while hospitalized for long-term bedside care.

The subjects were 264 patients hospitalized for long-term bedside care. The FILS was used to assess the subjects' mode of food intake on the admission and survey dates. The FILS score was used to divide the patients into three stages: no oral intake, combined oral intake and alternative nutrition, and exclusively oral intake; the patients whose FILS stage on the survey date was different from that on the admission date were examined to determine whether there were any characteristic tendencies with regard to their age, sex, length of hospital stay, level of long-term care needed, primary illness, and dysphagia rehabilitation.

Overall, 6.8%, 9.8%, and 4.5% of the subjects showed improvement in the FILS stage, experienced deterioration of the FILS stage, and transitioned to exclusively oral intake, respectively. Further, 33.3% of the improved-FILS stage group were in their ≥90s. The results of the exact binomial test with the entire study cohort as the population proportion showed that there were significantly more females in the improved-FILS group. In addition, 83.3% of those who improved from no oral intake to exclusively oral intake had cerebrovascular disease. No difference in the length of hospital stay and level of long-term care needed was observed in either the improved-FILS or deteriorated-FILS group in comparison to their proportions in the entire study cohort. In the entire study cohort, a greater proportion of the subjects in the improved-FILS group underwent indirect or direct swallowing training than those in the deteriorated-FILS group; the improved-FILS group had no subjects who were assigned to watchful waiting.

Most patients who exhibited marked positive changes in their mode of food intake were females or patients with cerebrovascular disease. However, no characteristic attributes were observed among those whose FILS stage deteriorated.