The therapeutic effect and complications of oro-esophageal tube training in stroke patients

Effect of intermittent oro-esophageal tube feeding combined with continuous nursing intervention on patients with intracerebral hemorrhage after surgery

OBJECTIVES

To explore the impact of intermittent oro-esophageal tube feeding combined with continuous nursing intervention on postoperative recovery in patients with intracerebral hemorrhage.

METHODS

A retrospective study was conducted on 212 patients with intracerebral hemorrhage after surgery who were admitted to the Third People's Hospital of Yibin from January 2022 to December 2023. Patients were divided into two groups: the control group (108 patients), who received intermittent oro-esophageal tube feeding, and the observation group (104 patients), who received intermittent oro-esophageal tube feeding combined with continuous nursing intervention. Clinical data, National Institutes of Health Stroke Scale (NIHSS), Glasgow Coma Scale (GCS), and the Activity of Daily Living (ADL) scores, psychological status, nutritional indices (albumin, hemoglobin, transferrin), compliance, and nursing satisfaction were compared between the groups.

RESULTS

Post-intervention, the observation group had significantly lower NIHSS scores and higher GCS, hemoglobin, albumin, transferrin, and ADL scores compared to the control group (all P < 0.05). Additionally, ESCA scores in the observation group were significantly higher than those in the control group (P < 0.05). Nursing satisfaction in the observation group was 97.12%, compared to 83.3% in the control group (P = 0.033).

CONCLUSION

Intermittent oro-esophageal tube feeding combined with continuous nursing intervention improves neurological deficits, reduces brain injury, and promotes recovery of motor function and daily living abilities in patients with intracerebral hemorrhage after surgery.

Factors and predictive model for malnutrition in poststroke disabled patients: A multicenter cross-sectional study

BACKGROUND

Although malnutrition has been shown to influence the clinical outcome of poststroke disabled patients, the associated factors and the prediction model have yet to be uncovered.

OBJECTIVES

This study aims to assess the current prevalence and factors associated with malnutrition in poststroke disabled patients and establish a prediction model.

METHODS

A multicenter cross-sectional survey among Chinese poststroke disabled patients (≥18 y old) was conducted in 2021. Information on patients' basic data, medical history, Barthel Index, dysphagia, and nutritional status was collected. A multivariable logistic regression model was used to identify the factors that influence malnutrition. Nomogram was developed and internal validation was conducted using 5-fold cross-validation. External validation was performed using the data from a preliminary survey. Receiver operating characteristic (ROC) analysis, calibration curves, and decision curve analysis (DCA) were used to analyze the predictive value of the nomogram.

RESULTS

Four hundred fifty-seven cases were enrolled, with the prevalence of malnutrition as 71.77%. Age (aOR = 1.039, 95% CI: 1.006-1.078), pulmonary infection (aOR = 4.301, 95% CI: 2.268-14.464), dysphagia (aOR = 24.605, 95% CI: 4.966-191.058), total intake volume (aOR = 0.997, 95% CI: 0.995-0.999), Barthel Index (aOR = 0.965, 95% CI: 0.951-0.980), and nasogastric tube (aOR = 16.529, 95% CI: 7.418-52.518) as nutrition support mode (compared to oral intake) were identified as the associated factors of malnutrition in stroke-disabled patients (P < 0.05). ROC analysis showed that the area under the curve (AUC) for nomogram was 0.854 (95% CI: 0.816-0.892). Fivefold cross-validation showed the mean AUC as 0.829 (95% CI: 0.784-0.873). There were no significant differences between predicted and actual probabilities. The DCA revealed that the model exhibited a net benefit when the risk threshold was between 0 and 0.4.

CONCLUSIONS

Age, pulmonary infection, dysphagia, nutrition support mode, total intake volume, and Barthel Index were factors associated with malnutrition in stroke-related disabled patients. The nomogram based on the result exhibited good accuracy, consistency and values.

Can respiratory muscle training therapy effectively manage obstructive sleep apnea syndrome after stroke?: A protocol of systematic review and meta-analysis

BACKGROUND

This study will explore the effectiveness and safety of respiratory muscle training therapy (RMTT) for the treatment of patients with obstructive sleep apnea syndrome (OSAS) after stroke.

METHODS

In this study, we will systematically and comprehensively search Cochrane Library, PubMed, EMBASE, WANGFANG, VIP, Chinese Biomedical Literature Database, and China National Knowledge Infrastructure for relevant literature from their inception to March 1, 2020 without any limitations to language and publication status. We will consider any randomized controlled trials focusing on the effectiveness and safety of RMTT for the treatment of patients with OSAS after stroke. The study quality will be checked using Cochrane risk of bias tool, and statistical analysis will be performed utilizing RevMan 5.3 software.

RESULTS

This study will summarize and synthesize the current evidence of RMTT for the treatment of patients with OSAS following stroke.

CONCLUSION

The findings of this study will assess the present evidence for the benefits and harms of RMTT for treating OSAS after stroke, and will inform clinical practice and future research.

PROSPERO REGISTRATION NUMBER

PROSPERO CRD42020170355.