Malnutrition could Predict 3-month Functional Prognosis in Mild Stroke Patients: Findings from a Nationwide Stroke Registry

Background: Previous studies showed the inconsistent effects of malnutrition contributing to the poor prognosis of stroke. This study aims to explore the effect of malnutrition on 3 month functional prognosis of stroke patients with different stroke severity assessed by the national institute of health stroke scale (NIHSS). Methods: Patients with first-ever stroke were consecutively enrolled in a nationwide, multicenter, and prospective registry from March 2007 to January 2008. Nutritional status was assessed at admission. Malnutrition was defined by any abnormality of 6 nutrition indicators, including body mass index (BMI), mid-upper arm circumference (MUAC), triceps skinfold thickness (TSF), haemoglobin, albumin, and prealbumin. Stroke patients were classified into mild (NIHSS<8) and severe (NIHSS>8) groups. Multivariable logistic regression was performed to assess the risk of poor functional prognosis (modified Rankin Scale (mRS) >3) at 3-month follow-up in the mild or severe patients with malnutrition at admission. Results: A total of 755 patients with first-ever stroke were enrolled in the study. Multivariable analysis showed that malnutrition independently contributed to a higher risk of mRS 3-6 at 3-month for mild stroke patients [odds ratio (OR) 1.86, 95 % confidence interval (CI) 1.04-3.34], but didn't for severe stroke patients (OR 0.91, 95 % CI 0.53-1.54) after adjusting for confounders including age, NIHSS, and infection et al. After adjusting for the potential confounders, malnutrition was still an independent risk factor for 3-month poor functional prognosis in mild stroke patients. Conclusion: Further investigation may be needed to illustrate the effects of improving nutritional status on stroke patients.