Undernourished stroke patients may have more complications, worse outcomes

Patients who are undernourished when they enter the hospital with an acute ischaemic stroke—the most common type of stroke, in which blood flow to the brain is blocked—are likely to remain undernourished in the hospital and may have worse clinical outcomes, according to a report in the January issue of Archives of Neurology, one of the JAMA/Archives journals.

"Although under nutrition [a deficiency in overall calories or one or more nutrients] is common in medical, geriatric and stroke patients, its treatment has received little attention," the authors write as background information in the article. "Because under nutrition may influence clinical outcomes, it is important to assess nutritional status and treat under nutrition particularly during acute stage of stroke."

Sung-Hee Yoo, R.N., M.S., and colleagues at the University of Ulsan College of Medicine, Seoul, Korea, studied 131 acute ischemic stroke patients who underwent assessments of their nutritional status within 24 hours of hospital admission and again one week after their symptoms began. Complications were assessed immediately after admission to the hospital and continuously until patients left the hospital or transferred to a rehabilitation unit. Clinical outcomes were measured three months later.

Of the patients, 16 (12.2 percent) were insufficiently nourished when they were admitted to the hospital and 26 (19.8 percent) were undernourished after one week. Under nutrition at hospital admission was associated with under nutrition one week later and complications following the stroke, while under nutrition at one week predicted poor outcomes after three months.

"These results suggest that patients undernourished at admission do not recover well with general hospital diets and are more likely to have post stroke complications and that undernourished patients during hospitalization are more likely to develop poor functional outcomes," the authors write.

(Source: Archives of Neurology : Dong-Wha Kang : JAMA/Archives : February 2008)