PD440 - THE COEXISTENCE OF NEUROGENIC DYSPHAGIA AND GERIATRIC SYNDROMES PREDICTS PROLONGED HOSPITAL STAY AND DECREASED FUNCTIONAL INDEPENDENCE

PD440

THE COEXISTENCE OF NEUROGENIC DYSPHAGIA AND GERIATRIC SYNDROMES PREDICTS PROLONGED HOSPITAL STAY AND DECREASED FUNCTIONAL INDEPENDENCE

K. Amakasu^1,2,*, T. Inoue³, S. Kobayashi², A. Saito^2,4, N. Kamada⁵, A. Brown^2,6, A. Kasai^2,7, M. Furusawa², H. Yanagida^2,8, Y. Watanabe¹

¹Department of Rehabilitation, Shinrakuen Hospital, ²Graduate School of Health and Welfare, ³Department of Rehabilitation, Niigata University of Health and Welfare, ⁴Department of Nutrition, Yoshida Hospital, Niigata, ⁵Department of Rehabilitation, Nippon Medical School Hospital, Tokyo, ⁶Department of Nutrition, Kitanakagusuku wakamatsu Hospital, Okinawa, ⁷Department of Prevention and Care Science, Research Institute, National Center for Geriatrics and Gerontology, Aichi, ⁸Department of Rehabilitation, Jiseikai–Nerimatakanodai Hospital, Tokyo, Japan

Rationale: Neurogenic dysphagia and geriatric syndromes such as sarcopenia and malnutrition are risk factors for poor prognosis in patients with acute stroke, respectively. In this study, geriatric syndromes were represented by low phase angle (PhA), and we investigated the effect of their coexistence on clinical outcomes.

Methods: Patients aged >65 years with acute stroke from 2021–2024 were included. Baseline PhA was measured using bioelectrical impedance analysis within one week of rehabilitation initiation and defined using sex-specific median values (<4.6° for males, <3.9° for females) as low PhA. Dysphagia was defined as a Functional Oral Intake Scale score <5 and patients were classified normal, low PhA alone, dysphagia alone, and coexistence. Functional independence at discharge was assessed using the modified Rankin Scale (mRS) (0–2 independent, 3–5 non-independent). Prolonged hospital stay was defined as ≥57 days (75th percentile). Multivariate logistic regression analysis was performed to examine the effect of the coexistence of low PhA and dysphagia on functional independence and prolonged hospital stay.

Results: A total of 562 patients were analyzed: 228 (40.6%) normal, 91 (16.2%) low PhA alone, 129 (23.0%) dysphagia alone, and 114 (20.3%) coexistence. A total of 562 patients were analyzed. The prevalence of prolonged hospital stay increased across groups (11.8%, 16.5%, 37.2%, 48.2%), as non–independence at discharge (41.2%, 79.1%, 78.3%, 94.7%). In multivariate analyses, the coexistence of low PhA and dysphagia showed the highest odds for prolonged hospital stay (odds ratio [OR]=5.14, P<0.001) and non-independence (OR=9.38, P<0.001), exceeding those of either condition alone.

Conclusion: The coexistence of neurogenic dysphagia and geriatric syndromes was risk factor for poor prognosis in patients with acute stroke.

Disclosure of Interest: None declared