Analysis of nutritional status and functional recovery outcomes in stroke patients under nursing care

The nutritional status is a very vital predictor of stroke patient recovery, functional independence, muscle strength, and rehabilitation outcomes. Nevertheless, little is known about the association between the state of nutrition and functional recovery during the usual nursing care in hospitalized stroke patients especially when carried out in retrospective studies.

To examine the association between baseline nutritional status and functional recovery in stroke patients under hospital nursing care.

A retrospective cohort study of 500 stroke patients admitted to a tertiary teaching hospital from January 2023 to December 2025 was conducted. Nutritional status at admission was assessed using the Geriatric Nutritional Risk Index (GNRI), supported by anthropometric (BMI, mid-upper arm circumference) and functional (handgrip strength) measures. Functional recovery was evaluated via the Barthel Index (BI), Functional Independence Measure (FIM), handgrip strength, and ambulation status at admission and discharge. Multivariate linear regression adjusted for age, sex, stroke severity, comorbidities, dysphagia, and length of stay.

At admission, 234 patients were well-nourished, 177 at risk, and 89 malnourished. Malnourished patients were older, had higher comorbidity burdens, and lower baseline BI and FIM scores. Baseline nutritional status was significantly associated with functional improvement: well-nourished patients showed the largest gains (ΔBI 30.9 ± 9.6; ΔFIM 27.8 ± 10.1), while malnourished patients had the smallest (ΔBI 18.2 ± 8.1; ΔFIM 16.1 ± 9.0). Patients who improved their nutritional status during hospitalization achieved greater functional recovery. Multivariate regression identified serum albumin, handgrip strength, and mid-upper arm circumference as independent predictors of functional improvement.

Baseline nutritional status strongly predicts functional recovery in hospitalized stroke patients. Routine biochemical and anthropometric measures provide practical, clinically relevant insights, emphasizing the importance of early nutritional assessment and intervention to optimize rehabilitation outcomes.