Department of Internal Medicine, Østfold Hospital Trust Fredrikstad, 1603 Fredrikstad, Norway.
Clin Nutr. 2010 Oct;29(5):567-73. doi: 10.1016/j.clnu.2010.01.011. Epub 2010 Feb 21.
BACKGROUND & AIMS: Undernutrition after an acute stroke increases the risk of poor outcome. We wanted to examine the effect of individualized, nutritional support on weight loss and functional outcomes in stroke patients.
Acute stroke patients at nutritional risk were randomized to either individualized, nutritional care or routine care while in hospital. Patients in the intervention group received an individualized treatment plan aiming to prevent weight loss. In accordance with routine care, the controls did not have such a treatment plan. Patients were reviewed at follow-up after three months. Primary outcome measure was the percentage of patients with weight loss ≥5%. Secondary outcomes measures were quality of life (QoL), handgrip strength and length of hospital stay. This trial is registered with ClinicalTrials.gov, number NCT00163007.
At follow-up, 20.7% of the intervention group (n = 58) lost ≥5% weight compared with 36.4% in the control group (n = 66) (P = 0.055). The intervention group had a significantly higher increase in QoL score (P = 0.009) and in handgrip strength (P = 0.002). There was no difference in length of hospital stay.
Individualized, nutritional treatment strategy can prevent clinically significant weight loss and improve QoL in elderly acute stroke patients at nutritional risk.
急性脑卒中后营养不良会增加不良预后的风险。我们旨在研究个体化营养支持对脑卒中患者体重减轻和功能结局的影响。
有营养风险的急性脑卒中患者被随机分为个体化营养护理组或常规护理组，在住院期间接受治疗。干预组患者接受个体化治疗计划，以防止体重减轻。对照组则没有这样的治疗计划，按照常规护理进行。患者在三个月后进行随访。主要结局指标是体重减轻≥5%的患者比例。次要结局指标是生活质量（QoL）、手握力和住院时间。本试验在 ClinicalTrials.gov 注册，编号为 NCT00163007。
随访时，干预组（n=58）有 20.7%的患者体重减轻≥5%，而对照组（n=66）有 36.4%（P=0.055）。干预组 QoL 评分（P=0.009）和手握力（P=0.002）显著增加。住院时间无差异。
个体化营养治疗策略可以预防有营养风险的老年急性脑卒中患者体重显著减轻，并改善其生活质量。
