The effect of protein and calorie intake on prealbumin, complications, length of stay, and function in the acute rehabilitation inpatient with stroke.
BACKGROUND
Nutrition's impact on stroke rehabilitation outcomes is controversial. Existing studies utilize albumin without correcting for inflammation in nutritional assessments. Here, prealbumin was used and inflammation assessed to determine if nutrition impacts rehabilitation outcomes.


OBJECTIVE
Determine the effect of dietary intake on prealbumin level, number of complications, length of stay, and Functional Independence Measure (FIM) efficiency in rehabilitation stroke inpatients.


METHODS
Patients had admission and discharge prealbumin and C-reactive protein (CRP) levels drawn; and, weekly protein and calorie counts obtained. Patients were followed for number of complications, length of stay, and FIM efficiency.


RESULTS
Mean protein and calorie intake was 57.6 ± 16.2 g/d and 1452.2 ± 435.8 kcal/d, respectively. 77.6% of patients had normal prealbumin on admission with 94.9% on discharge. Prealbumin increased significantly from admission to discharge (22.3 ± 6.2 mg/dL vs. 24.6 mg/dL ± 5.1 mg/dL, P = 0.007). Number of complications and length of stay were predicted by CRP in regression models. Total, motor, and cognitive FIM efficiencies were not universally affected by prealbumin levels, protein intake, or calorie intake.


CONCLUSIONS
Nearly all hypoprealbuminemic stroke rehabilitation inpatients correct their levels eating a non-supplemented diet. Number of complications, length of stay, and functional outcomes in this patient are not affected by prealbumin levels, protein intake, or calorie intake.
Department of Physical Medicine and Rehabilitation at the Rehabilitation Institute of Michigan in the Detroit Medical Center, Wayne State University, Detroit, MI, USA.
Anthony J
AJ
Pellicane
Scott R
SR
Millis
Kim D D
KD
Barker
Kate E
KE
Temme
Anjum
A
Sayyad
Matthew C
MC
Oswald
Elliot J
EJ
Roth
D000328:Adult; D000368:Aged; D002097:C-Reactive Protein; D004185:Disability Evaluation; D002149:Energy Intake / Q000502:physiology*; D005260:Female; D006801:Humans; D007297:Inpatients; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011228:Prealbumin / Q000378:metabolism*; D011506:Proteins / Q000378:metabolism*; D020521:Stroke / Q000178:diet therapy / Q000378:metabolism; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome
D011228:Prealbumin; D011506:Proteins; D002097:C-Reactive Protein
Stroke; malnutrition; rehabilitation; treatment outcome