Factors influencing oral health in patients with acute stroke receiving enteral nutrition

Aim: International stroke guidelines highlight the importance of oral health and hygiene in stroke care—not only for enhancing patient comfort but also as a crucial intervention to reduce infection risks and complications. Despite this, limited research has examined the factors influencing oral health in post-stroke patients who are unable to eat orally and depend on nasogastric tube (NGT) feeding.

Materials and Methods: This study employed a cross-sectional and descriptive design. The study population comprised 72 patients who were admitted to the neurology intensive care unit of a university hospital in İzmir with an acute stroke diagnosis between June 2020 and August 2021. Data collection tools included the Glasgow Coma Scale (GCS), the National Institutes of Health Stroke Scale (NIHSS), the Bedside Oral Assessment Scale (BOAS), and the Patient Information Form. Statistical analyses were performed using Pearson Correlation, Independent-Samples T-test, ANOVA, and Post Hoc-Tukey analysis.

Results: The mean oral health score on the first day of hospitalization was 13.03±1.31, increasing to 16.25±3.40 by the seventh day. Statistical analysis confirmed that this difference was statistically significant (p<0.05). Additionally, higher oral health scores were significantly associated with increasing age, smoking habits, presence of chronic illness, history of stroke, presence of dysphagia, impaired consciousness, and greater stroke severity.

Conclusion: This study found that stroke patients receiving nasogastric tube feeding exhibited poor oral health. Additionally, factors such as advanced age, gender, dysphagia, stroke type, stroke severity, and level of consciousness significantly influenced oral health status. These findings emphasize the need for comprehensive oral care protocols in stroke patients, particularly those on enteral nutrition, to reduce complications and improve overall health outcomes.