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    Please use this identifier to cite or link to this item: http://ir.cnu.edu.tw/handle/310902800/32197


    標題: One-Year Risk of Pneumonia and Mortality in Patients with Poststroke Dysphagia: A Nationwide Population-Based Study
    作者: Ho, Chung-Han
    Lin, Wen-Chih
    Hsu, Ya-Fang
    Lee, I-Hui
    Hung, Yi-Chieh
    貢獻者: Chi Mei Med Ctr, Dept Med Res
    Chia Nan Univ Pharm & Sci, Dept Hosp & Hlth Care Adm
    Chi Mei Med Ctr, Dept Phys Med & Rehabil
    Hung Surg Hosp, Dept Phys Med & Rehabil
    Taipei Vet Gen Hosp, Dept Neurol
    Natl Yang Ming Univ, Inst Brain Sci
    Chi Mei Med Ctr, Div Neurosurg, Dept Surg
    Chia Nan Univ Pharm & Sci, Dept Recreat & Healthcare Management
    關鍵字: Mortality
    nasogastric tube
    poststroke dysphagia
    pneumonia
    population
    based study
    日期: 2018-05
    上傳時間: 2019-11-15 15:44:48 (UTC+8)
    出版者: ELSEVIER SCIENCE BV
    摘要: Background: In the early stages of stroke, the use of a nasogastric tube can reduce complications such as malnutrition, dehydration, and pneumonia. However, its long-term efficacy is controversial. Methods: This retrospective cohort study used Taiwan's National Health Insurance Research Database to investigate associations among dysphagia, rate of readmission due to pneumonia, and mortality 1 year after stroke. Patients who had received their first stroke diagnosis and inpatient rehabilitation from January 1, 2006, to December 31, 2010, were enrolled. The presence of dysphagia was determined by the number of nasogastric tubes received (>= 2 was classified as dysphagia, < 2 as control). Kaplan-Meier plots with log-rank tests revealed differences between the 2 groups, and a Cox regression model was used to estimate the hazard ratio. Results: There were 5032 patients in the dysphagia group and 52,323 patients in the control group. The dysphagia group had a higher probability and incidence of pneumonia (18.78% versus 6.52%, P <.001 and adjusted hazard ratio [AHR] = 2.00, 95% confidence interval [CI] = 1.84-2.16) and a higher mortality rate (10.45% versus 4.77%, P <.001; AHR = 1.61, 95% CI = 1.46-1.79) 1 year after stroke. Conclusions: The association persisted until the 5-year poststroke time point. Our results suggest that prolonged nasogastric tube use has negative effects. Intensive evaluation of dysphagia and removal of the nasogastric tube in the early stages of stroke might reduce pneumonia incidence and mortality. (c) 2018 National Stroke Association. Published by Elsevier Inc. All rights reserved.
    link: http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2017.12.017
    關聯: Information & Management, v.27, n.5, pp.1311-1317
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