title: Impact of nutritional status on long-term functional outcomes of post-acute stroke patients in Taiwan.
abstract: Nutritional status is important in stroke care, but little is known regarding to the prognostic role of nutritional status on long-term functional outcomes among stroke survivors. The main purpose of this study was to evaluate to the prognostic role of nutritional status on long-term functional outcomes among stroke survivors. Data of acute stroke registry in Kaohsiung Veterans General Hospital were retrieved for analysis. Overall, 483 patients (mean age = 70.7 ± 10.3 years) with first-ever stroke were found. Among them, 95 patients (19.7%) were malnourished at admission, 310 (mean age = 70.4 ± 10.1 years, 63.5% males) survived for 6 months, and 244 (78.7%) had good functional outcomes. Subjects with poor functional outcomes were older (74.7 ± 8.9 vs. 69.0 ± 10.1 years, p < 0.001), more likely to be malnourished (56.2% vs. 26.6%, p < 0.001), to develop pneumonia upon admission (23.3% vs. 12.7%, p = 0.027), had a longer hospital stay (23.5 ± 13.9 vs. 12.5 ± 8.2 days, p < 0.001), had a higher National Institutes of Health Stroke Scale (NIHSS) score (12.9 ± 9.3 vs. 4.9 ± 4.3, p < 0.001), poorer stroke recovery (NIHSS improvement: 6.9% vs. 27.4%, p = 0.005), and poorer functional improvement (Barthel index = BI improvement in the first month: 31.4% vs. 138%, p < 0.001). Older age (odds ratio = OR) = 1.07, 95% confidence interval (CI = 1.03-1.11, p<0.001), baseline NIHSS score (OR = 1.23, 95%CI = 1.15-1.31, p < 0.001) and malnutrition at acute stroke (OR = 2.57, 95%CI: 1.29-5.13, p<0.001) were all independent risk factors for poorer functional outcomes. In conclusion, as a potentially modifiable factor, more attentions should be paid to malnutrition to promote quality of stroke care since the acute stage.
authors.affiliation: Division of Neurology, Department of Medicine, Kaohsiung Veterans General Hospital, No 386, Ta-Chung 1st Road, Kaohsiung 81362, Taiwan.
authors.forename: Hsiu-Chu
authors.initials: HC
authors.lastname: Shen
authors.forename: Hsueh-Fen
authors.initials: HF
authors.lastname: Chen
authors.forename: Li-Ning
authors.initials: LN
authors.lastname: Peng
authors.forename: Ming-Hsien
authors.initials: MH
authors.lastname: Lin
authors.forename: Liang-Kung
authors.initials: LK
authors.lastname: Chen
authors.forename: Chih-Kuang
authors.initials: CK
authors.lastname: Liang
authors.forename: Yuk-Keung
authors.initials: YK
authors.lastname: Lo
authors.forename: Shinn-Jang
authors.initials: SJ
authors.lastname: Hwang
mesh_terms: D000203:Activities of Daily Living; D000208:Acute Disease; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D009752:Nutritional Status / Q000502:physiology*; D011379:Prognosis; D020127:Recovery of Function; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D020521:Stroke / Q000401:mortality / Q000503:physiopathology; D000071939:Stroke Rehabilitation; D015996:Survival Rate / Q000639:trends; D013624:Taiwan / Q000453:epidemiology; D013997:Time Factors