Emerging malnutrition during hospitalisation independently predicts poor 3-month outcomes after acute stroke: data from a Chinese cohort

Questions exist regarding the causal relationship between malnutrition and stroke outcomes. This study aimed to determine whether nutritional status changes or malnutrition during hospitalisation could predict 3-month outcomes in acute stroke patients.During a 10-month period, patients who suffered their first stroke within 7 days after stroke onset were included in this prospective multi-centre study. The demographic parameters, stroke risk and severity factors, malnutrition risk factors and dysphagia were recorded. Nutritional status was assessed by 3 anthropometric and 3 biochemical indices. Changes in nutritional status were defined by comparing the admission values with the 2-week values. A Modified Rankin Scale score of 3-6 was defined as a poor outcome at the 3-month follow-up. Univariate and multiple logistic regression analyses were used to investigate the power of nutritional status changes in predicting poor patient outcomes.Data from 760 patients were analysed. Poor outcomes were observed in 264 (34.7%) patients. Malnutrition prevalence was 3.8% at admission and 7.5% after 2-weeks in hospital, which could not predict 3-month outcome. Emerging malnutrition was observed in 36 patients (4.7%) during the 2-week hospitalisation period and independently predicted poor 3-month outcomes after adjusting for confounding factors (odds ratio 1.37, 95% confidence interval 1.03-1.83).Emerging malnutrition during hospitalisation independently predicted poor 3-month outcomes in acute stroke patients in this study.目的：营养不良和脑卒中结局之间的因果关系仍然存在疑问。本研究的目的是确定住院期 间营养状态的变化或者营养不良能否预测急性脑卒中患者3个月后的结局。方法：在10个月 期间，首次卒中7天内的患者纳入该前瞻性多中心研究。记录人口统计学参数、脑卒中危险 因素和严重程度、营养不良的危险因素及是否有吞咽障碍。营养状态由3个人体测量学指标 和3个生化指标来评估。营养状态的变化是对比入院时和住院2周时的6个指标的变化。3个 月随访时改良的Rankin评分3-6分者认为是不良结局。单因素和多因素Logistic回归分析用于 检测营养状态的变化对不良结局预测的力度。结果：共有760例患者的数据纳入分析，其中 存在不良结局的有264（34.7%）例。入院时营养不良的患病率是3.8%，住院2周时是 7.5% ，而这均不能预测3 个月后的结局。住院2 周内新出现营养不良的患者有36 例 （4.7%），在纠正了混杂因素后仍可独立预测3个月后的结局（OR 1.37, 95% CI, 1.03- 1.83）。结论：本研究中急性卒中患者住院期间新出现的营养不良可以独立预测3个月后 的不良结局。.