Eating management and functional outcome of elderly patients with symptomatic ischemic stroke undergoing inpatient rehabilitation

Aim: The purpose of this study was to investigate whether, and to what extent, post-stroke eating management (EM) at admission to a rehabilitation ward is associated with functional outcome. Methods: This was a retrospective study comprising 716 consecutive elderly patients with first ever symptomatic ischemic stroke. Level of eating management was determined by Functional Independence Measurement (FIM) subscale scores relevant to eating management, where scores <= 5 points define low-eating management (Low-EM) ability and scores >5 indicate independent eating management. Data was analyzed by t-test, chi(2)-test, Pearson's correlation and by multiple linear regression analysis. Results: A total of 418 and 298 Low-EM and High-EM patients, respectively, were eligible for final analysis. Compared with High-EM, Low-EM patients were slightly older (P = 0.04), had longer rehabilitation stays (P < 0.001) and lower Mini-Mental State Examination (MMSE) scores (P < 0.001). Total FIM at admission and discharge were lower in Low-EMS, yet there was no statistically significant difference in total FIM gain on discharge between the two groups. Multiple linear regression analyses showed that total FIM at discharge was inversely associated with Low-EM at admission (beta-coefficient = -0.389, P < 0.001). Low-EM scores were independently predictive for higher total FIM gain at discharge (beta-coefficient = 0.125, P = 0.005). Conclusion: The findings suggest that impaired eating management on admission is associated with adverse functional outcome. However, patients presenting to rehabilitation with impaired eating management do obtain significant functional gains and should not be deprived of rehabilitation.