Weight loss after stroke: a population-based study from the Lund Stroke Register.
OBJECTIVE
Data on the prevalence and indicators of weight loss in population-based groups of stroke survivors are scarce. We aimed to find the predictors and indicators of weight loss >3 kg as a possible marker of malnutrition after stroke.


METHODS
We registered weight at baseline, after 4 months, and 1 year later in 305 survivors from a population-based cohort of first-ever stroke patients. Characteristics of the patients were registered at baseline and follow-ups, including glycosylated hemoglobin at baseline and follow-up II, eating difficulties at both follow-ups, and screening for depression at follow-up II. We used univariate and multivariate analyses to find baseline predictors and follow-up indicators related to weight loss >3 kg from baseline.


RESULTS
Among the 305 patients, 60% were male, the mean age was 72.5 years, and mean body mass index was 25.8 kg/m(2). The main stroke types were cerebral infarction (89%), intracerebral hemorrhage (7%), and subarachnoid hemorrhage (4%). Weight loss >3 kg was found in 74 (24%) patients (mean, -6.6 kg) after 4 months and in 79 patients (26%; mean, -8.3 kg) 1 year later. Severe stroke and elevated glycosylated hemoglobin levels were baseline predictors of weight loss >3 kg. Indicators associated with short-term weight loss (at follow-up I) were eating difficulties, low prealbumin value, and dependence (Barthel Index), whereas indicators associated with long-term weight loss (follow-up II) were eating difficulties, hemorrhagic stroke, and low prealbumin value.


CONCLUSIONS
Weight loss >3 kg after stroke indicates the need for closer observation regarding nutritional status. Monitoring of body weight may be useful, particularly among patients with severe stroke, eating difficulties, low prealbumin values, and impaired glucose metabolism.
Jönsson
Ann-Cathrin
AC
Department of Neurology, Lund University Hospital, S-221 85 Lund, Sweden. ann-cathrin.jonsson@skane.se
Lindgren
Ingrid
I
Norrving
Bo
B
Lindgren
Arne
A
D000203:Activities of Daily Living; D000368:Aged; D015992:Body Mass Index; D002543:Cerebral Hemorrhage / Q000150:complications; D002544:Cerebral Infarction / Q000503:physiopathology; D001068:Feeding and Eating Disorders; D005260:Female; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D008297:Male; D011228:Prealbumin / Q000378:metabolism; D011237:Predictive Value of Tests; D012042:Registries; D012720:Severity of Illness Index; D020521:Stroke / Q000150:complications / Q000209:etiology / Q000401:mortality / Q000503:physiopathology*; D013345:Subarachnoid Hemorrhage / Q000150:complications; D017741:Survivors; D013997:Time Factors; D015431:Weight Loss
D006442:Glycated Hemoglobin; D011228:Prealbumin