アブストラクト
Japanese
| Title | 入退院時のFood Intake Level Scaleを指標とした高齢の回復期脳卒中患者における摂食嚥下障害に影響する要因の検討 |
|---|---|
| Subtitle | ノート |
| Authors | 大坪博子1,4, 松原麻梨子2, 飯島伸介3, 平野偉与3, 大隅寛之1, 岸本桂子4 |
| Authors (kana) | |
| Organization | 1医療法人社団成仁会市ケ尾病院 薬剤科, 2歯科口腔外科, 3リハビリテーション科, 4昭和大学大学院薬学研究科社会薬学分野 |
| Journal | 医療薬学 |
| Volume | 50 |
| Number | 2 |
| Page | 45-55 |
| Year/Month | 2024 / 2 |
| Article | 報告 |
| Publisher | 日本医療薬学会 |
| Abstract | 「緒言」嚥下障害は脳卒中患者の37〜78%に認められる. 加えて, これらの摂食嚥下障害患者は, 嚥下障害のない患者と比較すると肺炎発症率や死亡率の割合は高く, 回復期リハビリテーション (回リハ) 病棟の脳卒中患者にとって嚥下障害の治療や予防は重要な課題である. また, 摂食嚥下障害は, サルコペニアや低栄養状態と関係し, 認知症の高齢者では嚥下障害の有病率が増加すると報告されている. さらに回リハ病棟の高齢入院患者の43.5%に栄養障害があり, 自宅復帰の独立した阻害因子とも報告されている. それ故, リハビリを栄養面から検討する「リハ栄養」については, こうしたエビデンスを基に総説やガイドラインも作成されている. 一方, リハビリを薬剤面から検討する「リハ薬剤」については, 機能的自立度評価表 (functional independence measure : FIM) と薬剤数や抗コリン薬, 潜在的に不適切薬剤 (potentially inappropriate medications : PIMs) との関連性を示した報告等はある. |
| Practice | 薬学 |
| Keywords | elderly stroke patients, dysphagia, FILS, polypharmacy, GNRI |
English
| Title | Investigation of Factors Affecting Dysphagia in Elderly Convalescent Stroke Patients Using the Food Intake Level Scale on Admission and Discharge as Indexes |
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| Subtitle | Notes |
| Authors | Hiroko Otsubo1,4, Mariko Matsubara2, Shinsuke Iijima3, Iyori Hirano3, Hiroyuki Osumi1, Keiko Kishimoto4 |
| Authors (kana) | |
| Organization | 1Department of Pharmacy, 2Department of Dentistry Oral Surgery, 3Department of Rehabilitation, Ichigao Hospital, 4Department of Social Pharmacy, Graduate School of Pharmacy, Showa University |
| Journal | Japanese Journal of Pharmaceutical Health Care and Sciences |
| Volume | 50 |
| Number | 2 |
| Page | 45-55 |
| Year/Month | 2024 / 2 |
| Article | Report |
| Publisher | Japanese Society of Pharmaceutical Health Care and Sciences |
| Abstract | We explored factors related to dysphagia in elderly convalescent stroke patients using the Food Intake Level Scale (FILS) on admission and discharge. Subjects included 405 stroke patients aged 65 years or older who were discharged from a comprehensive rehabilitation ward between April 2018 and May 2023. A univariate analysis was performed with 69 patients without dysphagia at admission FILS level 10 and with 336 patients with dysphagia at levels 1 - 9. Then, a multiple logistical analysis was used to examine factors associated with dysphagia on admission. Furthermore, patients with levels 1 - 9 on admission were grouped into patients with levels 10 (n = 79) and patients with levels 1 - 9 (n = 257) at discharge. After univariate analysis, multiple logistical analyses were performed to examine factors affecting dysphagia at discharge. Factors related to dysphagia on admission were Geriatric Nutritional Risk Index (GNRI) (OR = 5.54, P < 0.001), cognitive impairment (OR = 2.14, P = 0.0117), and BMI (OR = 2.21, P = 0.0141), while factors affecting dysphagia at discharge were GNRI (OR = 2.88, P = 0.003), polypharmacy (OR = 1.74, P = 0.047), and motor Functional Independence Measure efficiency (OR = 0.26, P = 0.026). There was no association with drugs that increased or decreased or caused a decline in swallowing function. It was speculated that GNRI was the factor positively associated with dysphagia on admission and discharge, and that polypharmacy was a positive factor in dysphagia at discharge. While it is already clear that appropriate rehabilitation and nutritional management are effective in improving swallowing in the rehabilitation ward, it is also useful to review polypharmacy during hospitalization. |
| Practice | Pharmaceutical sciences |
| Keywords | elderly stroke patients, dysphagia, FILS, polypharmacy, GNRI |
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