title: Combination of Low Body Mass Index and Low Serum Albumin Level Leads to Poor Functional Recovery in Stroke Patients.
abstract: BACKGROUND
  Nutritional status is associated with the functional recovery of stroke patients. This study aimed to examine the influence of the combination of body mass index (BMI) and serum albumin level on functional recovery in subacute stroke patients.
  
  
  METHODS
  This retrospective cohort study included 259 subacute stroke patients (mean age 68.9 ± 12.3 years). Patients were categorized into 4 groups according to their BMI and serum albumin level: group 1, low BMI (<18.5 kg/m2) and low serum albumin level (<3.5 g/dL); group 2, low BMI and high serum albumin level (≥3.5 g/dL); group 3, normal weight (≥18.5 kg/m2) and low serum albumin level; and group 4, normal weight and high serum albumin level. The outcome variable was the motor subscale of the Functional Independence Measure (M-FIM) effectiveness. We defined the first quartile of M-FIM effectiveness as poor functional recovery. Multivariate logistic regression analysis was performed to examine the influence of the combination of BMI and serum albumin level on poor functional recovery.
  
  
  RESULTS
  Multivariate logistic regression analysis adjusted for baseline characteristics (reference, group 4) showed that group 1 was mostly associated with a significant risk of poor functional recovery (odds ratio, 4.13; 95% confidence interval, 1.53-11.15).
  
  
  CONCLUSIONS
  Our results suggested that the combination of low BMI and low serum albumin level was more significantly associated with poor functional recovery in subacute stroke patients than either factor alone. The combination of BMI and serum albumin level should be taken into account when predicting functional recovery in subacute stroke patients.
authors.affiliation: Department of Rehabilitation, Tokyo Shinjuku Medical Center, Japan Community Health Care Organization, 5-1 Tsukudocho, Shinjuku-ku, Tokyo 162-8543, Japan; Graduate School of Comprehensive Human Sciences, University of Tsukuba, 3-29-1 Otsuka, Bunkyo-ku, Tokyo 112-0012, Japan. Electronic address: mcbb10ver@yahoo.co.jp.
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Kimura
authors.affiliation: Graduate School of Comprehensive Human Sciences, University of Tsukuba, 3-29-1 Otsuka, Bunkyo-ku, Tokyo 112-0012, Japan.
authors.forename: Minoru
authors.initials: M
authors.lastname: Yamada
authors.affiliation: Graduate School of Comprehensive Human Sciences, University of Tsukuba, 3-29-1 Otsuka, Bunkyo-ku, Tokyo 112-0012, Japan.
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Kakehi
authors.affiliation: Graduate School of Comprehensive Human Sciences, University of Tsukuba, 3-29-1 Otsuka, Bunkyo-ku, Tokyo 112-0012, Japan.
authors.forename: Atsunori
authors.initials: A
authors.lastname: Itagaki
authors.affiliation: Department of Rehabilitation, Tokyo Shinjuku Medical Center, Japan Community Health Care Organization, 5-1 Tsukudocho, Shinjuku-ku, Tokyo 162-8543, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Tanaka
authors.affiliation: Department of Rehabilitation Medicine, Tokyo Shinjuku Medical Center, Japan Community Health care Organization, 5-1 Tukudocho, Shinjuku-ku, Tokyo 162-8543, Japan.
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Muroh
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D016017:Odds Ratio; D020127:Recovery of Function / Q000502:physiology*; D012047:Rehabilitation Centers; D012189:Retrospective Studies; D012709:Serum Albumin / Q000378:metabolism*; D012720:Severity of Illness Index; D020521:Stroke / Q000503:physiopathology* / Q000628:therapy
chemical_list: D015415:Biomarkers; D012709:Serum Albumin
keywords: BMI; Stroke; albumin; functional recovery; nutrition