The Influencing Factors Of Enteral Nutrition Pattern Selectiong And The Clinical Outcomes In Hospitalized Stroke

ObjectiveTo find out the influencing factors of enteral nutrition pattern application and evaluate the clinical outcome after enteral nutrition support with commercial products in the hospitalized patients with stroke and provide the reference for improving the enteral nutrition therapy in stroke patients.MethodsThrough medical record review method,by checking on the records from Jan.2015 to Dec.2016 in a local hospital,total of 385 stroke patients accompanied with swallowing disorder were included.All of the patients accepted the nasogastric tube feeding either fed with commercial enteral nutrition products(group A)or home made homogenized food(group B).Data retrieved from the medical records included:history of diseases,with or without infectious complications,blood tests on admission and after the nutrition therapy,hospital stay duration,and medical cost.Using the unconditional logistic regression and multivariate regression,the factors influencing the application of enteral nutrition pattern were analyzed through SPSS21.0.The clinical outcomes and the medical cost of the patients were analyzed by t test and ?2test.All statistical tests were two-tailed.The significant level was set as ?=0.05.Results1.Among the 385 cases,group A had 185 and group B had 200 cases respectively.There were no significant differences between the two groups in the type of stroke,gender,age,and NRS2002 score,all P>0.05.2.Analysis of influencing factors of elemental nutrition pattern application Single factor analysis showed that age,occupation,type of medical insurance,accompanied with coronary heart disease,pulmonitis,pressure sore,or other infections,serum AST,ALB,GLOB,TC,and HDL-C,as well as peripheral blood total WBC and differential count(neutrophil and lymphocyte count).The unconditional logistic regression demonstrated pulmonary infection(P=0.025,OR=1.91,95%CI=1.084,3.367),neutrophil differential count(P<0.001,OR=1.19,95%CI=1.106,1.282),and HDL-C(P=0.001,OR=0.255,95%CI=0.112,0.579).3.The clinical outcomes of the patients after enteral nutrition therapy by commercial products.The levels of serum TP and ALB were increased,while the levels of blood UA,TBIL,Hb,HCT.WBC,and neutrophil count were decreased after the nutrition support(all P<0.05).4.The average hospital stay were(24.04±14.47)and(27.45±16.44)days in groupA and B patients respectively,P=0.032.The mean medical costs were(77273.78±5681.89)and(58425.91±4131.96)yuan in group A and B patients respectively,P=0.007.Conclusions1.The influencing factors on enteral nutrition pattern including pulmonary infection,neutrophil differential count.2.The enteral nutrition using commercial products makes shorter hospital stay,but higher medical cost than that using homemade homogenized food for the stroke in-patients.3.The enteral nutrition support using commercial products could improve the outcome of the stroke in-patient.