Abstract TP338: Evaluating Predictors of Diet Trajectory During Acute Stroke Hospitalization

Introduction: Dysphagia is highly prevalent amongst acute stroke patients and affects inpatient swallow resource use and disability outcomes. Patient characteristics contributing to diet evolution during acute stroke hospitalization are currently unclear. This study examined predictors of diet trajectory in patients hospitalized with acute ischemic stroke (AIS) and intracerebral hemorrhage (ICH). Methods: We retrospectively examined data from an IRB-approved stroke registry at two Comprehensive Stroke Centers (CSC) between 10/24/2022 and 8/30/2024. We included hospitalized patients with new AIS or ICH with pre-stroke modified Rankin Scale (mRS) 0-1. Patients were grouped into four diet trajectory groups based on formal speech therapist assessment on admission and at discharge: 1. NPO:NPO, 2. NPO:Oral, 3. Oral:NPO, 4. Oral:Oral. Patient characteristics (demographics, comorbidities, initial NIHSS, acute stroke treatment, length of stay (LOS), initial neurological symptoms, discharge disposition) were analyzed according to diet trajectory groups. A correlation matrix was constructed followed by stepwise linear regression. Logistic regression modeling was used for variables with p<0.10 to identify predictors of diet trajectory. Results: A total of 542 patients met study criteria (AIS: 475, ICH: 67). Patient characteristics correlating to diet trajectory were age (p=0.002), Hispanic ethnicity (p=0.025), history of atrial fibrillation (p<0.001), endovascular treatment (p<0.001), initial NIHSS (p<0.001), LOS (p<0.001), and presence of aspiration precautions (p<0.001). Initial stroke symptoms (weakness/paresis, altered consciousness, aphasia/language disturbance, absence of neurological symptoms) and discharge disposition were also significantly correlated to diet trajectory with p<0.001. Conclusion: In patients with new AIS or ICH, key demographic factors, endovascular treatment, LOS, discharge disposition, and initial stroke severity were significant predictors of diet trajectory. The independent predictors identified in our analysis fully accounted for diet trajectory in acute stroke patients. Results are being used to develop clinical protocols that predict diet trajectory and assist with efficient mobilization of inpatient swallow resources.