Being at risk of malnutrition predicts poor outcomes at 3 months in acute ischemic stroke patients

被引:64
作者
Cai, Zhong-ming [1 ]
Wu, Yan-zhi [1 ]
Chen, Hao-man [1 ]
Feng, Ren-qian [1 ]
Liao, Cheng-wei [1 ]
Ye, Sheng-lie [1 ]
Liu, Zhi-peng [1 ]
Zhang, Man-man [2 ]
Zhu, Bei-lei [2 ]
机构
[1] Wenzhou Med Univ, Clin Med Sch 1, Dept Med, Wenzhou, Peoples R China
[2] Wenzhou Med Univ, Dept Neurol, Affiliated Hosp 1, Wenzhou, Peoples R China
关键词
NUTRITION; UNDERNUTRITION; MORTALITY;
D O I
10.1038/s41430-020-0605-8
中图分类号
R15 [营养卫生、食品卫生]; TS201 [基础科学];
学科分类号
100403 ;
摘要
Background Malnutrition is confirmed to be associated with poor outcomes in stroke patients. The present study aimed to confirm that being at risk of malnutrition assessed by Nutritional Risk Screening Tool 2002 (NRS-2002) and the Controlling Nutritional Status (CONUT) score predicts poor outcomes at 3 months in acute ischemic stroke (AIS) patients. Methods In total, 682 patients with AIS were recruited within 7 days of stroke onset consecutively and 110 were dropped out. They were screened for risk of malnutrition using NRS-2002 and the CONUT score. The primary outcome is the follow-up modified Rankin Scale (mRS) score. Poor outcomes were defined as an (mRS) score >= 3 at 3 months post discharge. Results There was a significant difference in the mRS score at 3 months between patients at risk of malnutrition compared to those not at risk assessed by NRS-2002(P < 0.001) and CONUT (P = 0.011). The logistic regression model showed that the risk of malnourishment (according to NRS-2002), low risk of malnourishment (according to CONUT), and the moderate-to-severe risk of malnourishment (according to CONUT) were associated with higher risk of poor outcomes at 3 months (P < 0.001, P = 0.033, and P = 0.007). The multivariate logistic regression model (adjusted for confounding factors) demonstrated that the risk of malnourishment, according to the NRS-2002, was associated with the increasing risk of poor outcomes at 3 months (odds ratio = 2.31; 95% CI: 1.24-4.30; P = 0.008). Conclusions The risk of malnutrition assessed by NRS-2002 and CONUT can predict poor outcomes at 3 months in AIS patients. NRS-2002 is superior to CONUT in predicting poor outcomes at 3 months.
引用
收藏
页码:796 / 805
页数:10
相关论文
共 37 条
[1]   CLASSIFICATION OF SUBTYPE OF ACUTE ISCHEMIC STROKE - DEFINITIONS FOR USE IN A MULTICENTER CLINICAL-TRIAL [J].
ADAMS, HP ;
BENDIXEN, BH ;
KAPPELLE, LJ ;
BILLER, J ;
LOVE, BB ;
GORDON, DL ;
MARSH, EE ;
KASE, CS ;
WOLF, PA ;
BABIKIAN, VL ;
LICATAGEHR, EE ;
ALLEN, N ;
BRASS, LM ;
FAYAD, PB ;
PAVALKIS, FJ ;
WEINBERGER, JM ;
TUHRIM, S ;
RUDOLPH, SH ;
HOROWITZ, DR ;
BITTON, A ;
MOHR, JP ;
SACCO, RL ;
CLAVIJO, M ;
ROSENBAUM, DM ;
SPARR, SA ;
KATZ, P ;
KLONOWSKI, E ;
CULEBRAS, A ;
CAREY, G ;
MARTIR, NI ;
FICARRA, C ;
HOGAN, EL ;
CARTER, T ;
GURECKI, P ;
MUNTZ, BK ;
RAMIREZLASSEPAS, M ;
TULLOCH, JW ;
QUINONES, MR ;
MENDEZ, M ;
ZHANG, SM ;
ALA, T ;
JOHNSTON, KC ;
ANDERSON, DC ;
TARREL, RM ;
NANCE, MA ;
BUDLIE, SR ;
DIERICH, M ;
HELGASON, CM ;
HIER, DB ;
SHAPIRO, RA .
STROKE, 1993, 24 (01) :35-41
[2]   Impact of Premorbid Malnutrition and Dysphagia on Ischemic Stroke Outcome in Elderly Patients: A Community-Based Study [J].
Aliasghari, Fereshteh ;
Izadi, Azimeh ;
Khalili, Mohammad ;
Farhoudi, Mehdi ;
Ahmadiyan, Shahram ;
Deljavan, Reza .
JOURNAL OF THE AMERICAN COLLEGE OF NUTRITION, 2019, 38 (04) :318-326
[3]   ESPEN guideline clinical nutrition in neurology [J].
Burgos, Rosa ;
Breton, Irene ;
Cereda, Emanuele ;
Desport, Jean Claude ;
Dziewas, Rainer ;
Genton, Laurence ;
Gomes, Filomena ;
Jesus, Pierre ;
Leischker, Andreas ;
Muscaritoli, Maurizio ;
Poulia, Kalliopi-Anna ;
Preiser, Jean Charles ;
Van der Marck, Marjolein ;
Wirth, Rainer ;
Singer, Pierre ;
Bischoff, Stephan C. .
CLINICAL NUTRITION, 2018, 37 (01) :354-396
[4]  
Cederholm T, 2019, CLIN NUTR, V38, P1480, DOI [10.1016/j.clnu.2019.02.033, 10.1016/j.clnu.2018.08.002, 10.1002/jcsm.12383, 10.1002/jpen.1440]
[5]   Reappraisal of heart rate variability in acute ischemic stroke [J].
Chen, Chien-Fu ;
Lai, Chiou-Lian ;
Lin, Hsiu-Fen ;
Liou, Li-Min ;
Lin, Ruey-Tay .
KAOHSIUNG JOURNAL OF MEDICAL SCIENCES, 2011, 27 (06) :215-221
[6]   Effect of malnutrition after acute stroke on clinical outcome [J].
Davalos, A ;
Ricart, W ;
GonzalezHuix, F ;
Soler, S ;
Marrugat, J ;
Molins, A ;
Suner, R ;
Genis, D .
STROKE, 1996, 27 (06) :1028-1032
[7]   Poor nutritional status on admission predicts poor outcomes after stroke - Observational data from the FOOD trial [J].
Dennis, M .
STROKE, 2003, 34 (06) :1450-1455
[8]  
DEULIBARRI JI, 2005, NUTR HOSP, V20, P38
[9]   An analytic appraisal of nutrition screening tools supported by original data with particular reference to age [J].
Elia, Marinos ;
Stratton, Rebecca J. .
NUTRITION, 2012, 28 (05) :477-494
[10]  
FerroLuzzi A, 1995, WHO TECH REP SER, V854, P1