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Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
Impact of Premorbid Malnutrition and Dysphagia on Ischemic Stroke Outcome in Elderly Patients: A Community-Based
Fereshteh Aliasghari1,2, Azimeh Izadi1,2, Mohammad Khalili3,4
1a Department of Biochemistry and Diet Therapy, School of Nutrition and Food Science , Nutrition Research Center, Tabriz University of Medical Sciences , Tabriz , Iran.
Objective:
The present study was performed to assess nutritional status and its relationship with clinical outcomes in elderly stroke patients.
Method:
In this cross-sectional study, 253 stroke patients were studied. Mini Nutritional Assessment (MNA) was used to assign patients to three groups: malnourished, at risk of malnutrition, and well nourished. Northwestern Dysphagia Patient Check Sheet was administered to all patients. Anthropometric measures, including body mass index (BMI), calf circumferences (CC), mid-arm circumferences (MAC), and triceps skinfold thickness were brought out. In addition, National Institutes of Health Stroke Scale (NIHSS), modified Rankin Scale (mRS), and biochemical tests were performed.
Results:
Of 253 patients, 34.4% were malnourished, 42.3% were at risk of malnutrition, and 23.3% were well nourished. The malnourished patients had significantly lower BMI, CC, and MAC (p < 0.05). The levels of albumin and high-sensitivity C-reactive protein were significantly different among the groups (p < 0.001). The admission and 3-month follow-up mRS scores, as well as dysphagia, were significantly higher in the malnourished patients and those at risk of malnutrition (p < 0.001). In addition, mRS scores at admission and 3-month follow-up scores, as well as the length of hospital stay (LOS), were significantly correlated with MNA score, dysphagia, BMI, CC, MAC, albumin, and high-sensitivity C-reactive protein (p < 0.05). Significant unadjusted associations were observed among MNA scores, BMI, CC, MAC, dysphagia scores, NIHSS scores, length of hospital stay (LOS), albumin, hs-C-reactive protein (hs-CRP), and erythrocyte sedimentation rate (ESR) with a poor outcome. With a multivariate logistic regression analysis, NIHSS scores and MNA scores remained significantly associated with the poor outcome in patients with ischemic stroke.
Conclusions:
The findings of the present study underline the importance of nutritional status in elderly stroke patients.
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