Impact of premorbid undernutrition on outcome in stroke patients

Davis, James P., Wong, Andrew A., Schluter, Philip J., Henderson, Robert D., OSullivan, John D. and Read, Stephen J. (2004) Impact of premorbid undernutrition on outcome in stroke patients. Stroke, 35 8: 1930-1934. doi:10.1161/01.STR.0000135227.10451.c9


Author Davis, James P.
Wong, Andrew A.
Schluter, Philip J.
Henderson, Robert D.
OSullivan, John D.
Read, Stephen J.
Title Impact of premorbid undernutrition on outcome in stroke patients
Journal name Stroke   Check publisher's open access policy
ISSN 0039-2499
Publication date 2004-08-01
Sub-type Article (original research)
DOI 10.1161/01.STR.0000135227.10451.c9
Volume 35
Issue 8
Start page 1930
End page 1934
Total pages 5
Editor V. Hachinski
Place of publication Hagerstown, MD
Publisher Lippincott Williams & Wilkins
Language eng
Subject C1
321099 Clinical Sciences not elsewhere classified
730199 Clinical health not specific to particular organs, diseases and conditions
110399 Clinical Sciences not elsewhere classified
Abstract Background and Purpose - To assess the prevalence of premorbid undernutrition and its impact on outcomes 1 month after stroke. Methods - The study recruited from consecutive stroke admissions during a 10-month period. Premorbid nutritional status ( using the subjective global assessment [SGA]), premorbid functioning ( modified Rankin scale [MRS]), and stroke severity ( National Institutes of Health Stroke Scale [NIHSS] score) were assessed at admission. The associations between premorbid nutritional status, poor outcome ( defined as MRS greater than or equal to 3), and mortality were examined before and after adjustment for confounding variables, including age, gender, stroke risk factors, stroke severity, and admission serum albumin. Results - Thirty of 185 patients were assessed as having undernutrition at admission. Significant unadjusted associations were observed between undernutrition and poor outcome (odds ratio [OR], 3.4; 95% CI, 1.3 to 8.7; P = 0.01), and mortality (OR, 3.1, 95% CI, 1.3 to 7.7; P = 0.02) at 1 month. NIHSS, age, and premorbid MRS were also significantly associated with poor outcomes. After adjustment for these factors, the effect size of associations remained important but not significant ( poor outcome: OR, 2.4; 95% CI, 0.7 to 9.0, P = 0.18; mortality: OR, 3.2; 95% CI, 1.0 to 10.4, P = 0.05). Conclusions - Premorbid undernutrition, as assessed using the SGA, appears to be an independent predictor of poor stroke outcome. Stroke prevention strategies should target undernutrition in the population at risk for stroke to improve outcomes.
Keyword Clinical Neurology
Peripheral Vascular Disease
Stroke
Outcome
Diet
Nutrition-associated Complications
Subjective Global Assessment
Scale
Rehabilitation
Malnutrition
Trials
Reliability
Recognition
Admission
Recovery
Q-Index Code C1

 
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Created: Wed, 15 Aug 2007, 15:05:09 EST