Nutrition program selection in acute ischemic stroke patients with GI hemorrhage

Area of Science:

• Neurology
• Gastroenterology
• Nutritional Science

Background:

• Gastrointestinal (GI) hemorrhage is linked to severe neurologic impairment in stroke patients.
• Effective nutritional support is critical for managing these complex cases.

Purpose of the Study:

• To compare the efficacy of moderate feeding versus trophic feeding with supplemental parenteral nutrition in acute ischemic stroke patients experiencing GI hemorrhage.
• To evaluate the impact of nutritional interventions on patient outcomes.

Main Methods:

• A retrospective study of ischemic stroke patients with GI hemorrhage (January 2014 - December 2018).
• Patients were divided into two groups: moderate feeding (≥70% caloric uptake) and trophic feeding (16-25% energy expenditure) with parenteral nutrition.
• Outcomes assessed included mortality, Glasgow Coma Scale (GCS), and Glasgow Outcome Scale (GOS).

Main Results:

• The moderate feeding group (30 patients) showed significantly lower mortality compared to the trophic feeding group (32 patients).
• Patients receiving moderate feeding had higher GCS scores at discharge, indicating better conscious state and less neurological severity.
• The GOS scores at 3 months post-discharge were also significantly higher in the moderate feeding group, suggesting improved functional recovery.

Conclusions:

• Moderate feeding demonstrates a superior effect on patient outcomes compared to trophic feeding with supplemental parenteral nutrition.
• This nutritional strategy is associated with reduced mortality and enhanced neurological recovery in acute ischemic stroke patients with GI hemorrhage.