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蛋白质和热量摄入对急性康复住院脑卒中患者前白蛋白、并发症、住院时间和功能的影响。

The effect of protein and calorie intake on prealbumin, complications, length of stay, and function in the acute rehabilitation inpatient with stroke.

机构信息

Department of Physical Medicine and Rehabilitation at the Rehabilitation Institute of Michigan in the Detroit Medical Center, Wayne State University, Detroit, MI, USA.

出版信息

NeuroRehabilitation. 2013;33(3):367-76. doi: 10.3233/NRE-130966.

Abstract

BACKGROUND

Nutrition's impact on stroke rehabilitation outcomes is controversial. Existing studies utilize albumin without correcting for inflammation in nutritional assessments. Here, prealbumin was used and inflammation assessed to determine if nutrition impacts rehabilitation outcomes.

OBJECTIVE

Determine the effect of dietary intake on prealbumin level, number of complications, length of stay, and Functional Independence Measure (FIM) efficiency in rehabilitation stroke inpatients.

METHODS

Patients had admission and discharge prealbumin and C-reactive protein (CRP) levels drawn; and, weekly protein and calorie counts obtained. Patients were followed for number of complications, length of stay, and FIM efficiency.

RESULTS

Mean protein and calorie intake was 57.6 ± 16.2 g/d and 1452.2 ± 435.8 kcal/d, respectively. 77.6% of patients had normal prealbumin on admission with 94.9% on discharge. Prealbumin increased significantly from admission to discharge (22.3 ± 6.2 mg/dL vs. 24.6 mg/dL ± 5.1 mg/dL, P = 0.007). Number of complications and length of stay were predicted by CRP in regression models. Total, motor, and cognitive FIM efficiencies were not universally affected by prealbumin levels, protein intake, or calorie intake.

CONCLUSIONS

Nearly all hypoprealbuminemic stroke rehabilitation inpatients correct their levels eating a non-supplemented diet. Number of complications, length of stay, and functional outcomes in this patient are not affected by prealbumin levels, protein intake, or calorie intake.

摘要

背景

营养对中风康复结果的影响存在争议。现有研究在营养评估中使用白蛋白而不纠正炎症。在这里,使用前白蛋白并评估炎症,以确定营养是否影响康复结果。

目的

确定饮食摄入对康复中风住院患者前白蛋白水平、并发症数量、住院时间和功能独立性测量(FIM)效率的影响。

方法

患者入院和出院时均抽取前白蛋白和 C 反应蛋白(CRP)水平,并每周记录蛋白质和卡路里摄入量。对患者的并发症数量、住院时间和 FIM 效率进行随访。

结果

平均蛋白质和卡路里摄入量分别为 57.6 ± 16.2 g/d 和 1452.2 ± 435.8 kcal/d。入院时 77.6%的患者前白蛋白正常,出院时 94.9%的患者前白蛋白正常。前白蛋白从入院到出院显著增加(22.3 ± 6.2 mg/dL 与 24.6 mg/dL ± 5.1 mg/dL,P = 0.007)。并发症数量和住院时间可通过 CRP 在回归模型中预测。总、运动和认知 FIM 效率不受前白蛋白水平、蛋白质摄入量或卡路里摄入量的普遍影响。

结论

几乎所有低前白蛋白血症的中风康复住院患者通过食用非补充饮食来纠正其水平。在这些患者中,并发症数量、住院时间和功能结局不受前白蛋白水平、蛋白质摄入量或卡路里摄入量的影响。

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