Objective: Questions exist regarding the causal relationship between malnutrition and stroke outcomes. This study aimed to determine whether nutritional status changes or malnutrition during hospitalisation could predict 3-month outcomes in acute stroke patients.
Methods: During a 10-month period, patients who suffered their first stroke within 7 days after stroke onset were included in this prospective multi-centre study. The demographic parameters, stroke risk and severity factors, malnutrition risk factors and dysphagia were recorded. Nutritional status was assessed by 3 anthropometric and 3 biochemical indices. Changes in nutritional status were defined by comparing the admission values with the 2-week values. A Modified Rankin Scale score of 3-6 was defined as a poor outcome at the 3-month follow-up. Univariate and multiple logistic regression analyses were used to investigate the power of nutritional status changes in predicting poor patient outcomes.
Results: Data from 760 patients were analysed. Poor outcomes were observed in 264 (34.7%) patients. Malnutrition prevalence was 3.8% at admission and 7.5% after 2-weeks in hospital, which could not predict 3-month outcome. Emerging malnutrition was observed in 36 patients (4.7%) during the 2-week hospitalisation period and independently predicted poor 3-month outcomes after adjusting for confounding factors (odds ratio 1.37, 95% confidence interval 1.03-1.83).
Conclusions: Emerging malnutrition during hospitalisation independently predicted poor 3-month outcomes in acute stroke patients in this study.
目的：营养不良和脑卒中结局之间的因果关系仍然存在疑问。本研究的目的是确定住院期 间营养状态的变化或者营养不良能否预测急性脑卒中患者3个月后的结局。方法：在10个月 期间，首次卒中7天内的患者纳入该前瞻性多中心研究。记录人口统计学参数、脑卒中危险 因素和严重程度、营养不良的危险因素及是否有吞咽障碍。营养状态由3个人体测量学指标 和3个生化指标来评估。营养状态的变化是对比入院时和住院2周时的6个指标的变化。3个 月随访时改良的Rankin评分3-6分者认为是不良结局。单因素和多因素Logistic回归分析用于 检测营养状态的变化对不良结局预测的力度。结果：共有760例患者的数据纳入分析，其中 存在不良结局的有264（34.7%）例。入院时营养不良的患病率是3.8%，住院2周时是 7.5% ，而这均不能预测3 个月后的结局。住院2 周内新出现营养不良的患者有36 例 （4.7%），在纠正了混杂因素后仍可独立预测3个月后的结局（OR 1.37, 95% CI, 1.03- 1.83）。结论：本研究中急性卒中患者住院期间新出现的营养不良可以独立预测3个月后 的不良结局。.