Impact of energy intake on the survival rate of patients with severely ill stroke.
BACKGROUND
Stroke accounts for approximately 10% of all deaths. We examined whether energy intake influences the survival rate of severely ill stroke patients.


METHODS
We analyzed 86 consecutive severely ill stroke patients. Patients' background was compared between survivors and non-survivors. Average energy intakes in seven different periods from day one to seven following neurosurgical care unit (NCU) admission were compared between two groups, to examine which period is proper to show an energy difference. Groups were stratified by average total energy intake (group E-I, -II, -III, and -IV; ≤.25, 8.25-16.5, 16.5-25, and >25kcal/kg/day, respectively), and cumulative survival rate for 90 days after NCU admission was analyzed. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated to examine the effect of confounder factors.


RESULTS
Patients' background did not differ significantly between the two groups. Average daily energy intake for the first seven NCU days of non-survivors was significantly lower than that of survivors (p=0.034). The survival rate of group E-II was significantly higher than that of group E-I, which was set as a reference (p=0.030). The adjusted HR of E-II was also significantly lower than that of group E-I (HR=0.19, p=0.047), although E-III did not show significance (HR=0.52, p=0.279).


CONCLUSIONS
Energy intake assessment should be conducted for at least seven days following NCU admission. An average total energy intake ranging from 8.25 to 16.5 kcal/kg/day and enteral feeding increases survival rate in severely ill stroke patients.
Department of Food Science and Nutrition, Mukogawa Women's University, Hyogo, Japan.
Maki
M
Wakita
Akatsuki
A
Wakayama
Yuko
Y
Omori
Satomi
S
Ichimaru
Teruyoshi
T
Amagai
D000368:Aged; D000369:Aged, 80 and over; D002149:Energy Intake; D004750:Enteral Nutrition; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D020521:Stroke / Q000401:mortality* / Q000503:physiopathology / Q000628:therapy*; D015996:Survival Rate