Malnutrition in Acute Stroke Patients Stratified by Stroke Severity- A Hospital Based Study

Stroke results in high mortality with tremendous health care burden. Malnutrition is frequently observed in patients after stroke. This study was designed to explore the nutritional status in the acute stage of stroke aiming at exploring factors related to malnutrition after stroke.

This was a hospital based, prospective, observational study recruiting cerebrovascular diseases patients hospitalized for acute management. Patients suffered from all kinds of cerebrovascular diseases hospitalized for management within 30 days after onset were consecutively recruited in the study hospitals. Stroke severity was evaluated by National Institutes of Health Stroke Scale, functional status by Barthel index, and global outcome by modified Rankin Scale. Cognitive function was evaluated by Mini-Mental State Examination. Nutritional status was assessed by Mini Nutritional Assessment (MNA), stratified by 1) adequate nutritional status, MNA ≥ 24; 2) protein-calorie malnutrition, MNA less than 17; 3) at risk of malnutrition, MNA between 17 and 23.5.

There were 231 cerebral infarction patients recruited at 13.5 days (25-75%: 5.0-17.0) after stroke onset with mild stroke severity 71.4% and severe 10.4% with nasogastric tube insertion in 14%. Malnutrition was identified in 12.1% with 54.1% at risk of malnutrition. Factor related to malnutrition was severe stroke severity with dependency. Patients with old age, hypertension, and diabetes mellitus tended to have malnutrition or risk of malnutrition.

Nutritional status was poor in stroke patients across all stroke severities within weeks. Further longitudinal outcome studies to identify the poor outcome and the evolution of nutritional status are warranted.