Zhang Jing, Zhao Xingquan, Wang Anxin, Zhou Yong, Yang Bo, Wei Na, Yu Dandan, Lu Jingjing, Chen Shengyun, Wang Yilong, Wang Chunxue, Xue Rong, Zhang Yanqiu, Li Yansheng, Yu Ling, Wang Shaoshi, Chen Zhenli, Zheng Tianheng, Zhang Zhuo, Xia Meng, He Maolin, Li Wei, Zhang Zhaohui, Zeng Fei, Chen Shengdi, Fu Yi, Liu Guidong, Wang Lijuan, Huang Zhiheng, Ma Jianguo, Mu Fengqun, Xu Yun, Huang Rong, Wang Lin, Wang Yongjun
Department of Neurology, Beijing Tian Tan Hospital, Capital Medical University, China National Clinical Research Center for Neurological Disease (NCRC-ND), Center of Stroke, Beijing Institute for Brain Disorders, Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China.
Tianjin Medical University General Hospital, Tianjing, China.
Asia Pac J Clin Nutr. 2015;24(3):379-86. doi: 10.6133/apjcn.2015.24.3.13.
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.
营养不良与卒中预后之间的因果关系存在疑问。本研究旨在确定住院期间营养状况的变化或营养不良是否能预测急性卒中患者3个月后的预后。
在为期10个月的时间里，本前瞻性多中心研究纳入了卒中发病后7天内首次发生卒中的患者。记录人口统计学参数、卒中风险和严重程度因素、营养不良风险因素及吞咽困难情况。通过3项人体测量指标和3项生化指标评估营养状况。营养状况的变化通过比较入院时的值与2周时的值来定义。改良Rankin量表评分为3 - 6分被定义为3个月随访时的不良预后。采用单因素和多因素逻辑回归分析来研究营养状况变化对预测患者不良预后的能力。
分析了760例患者的数据。264例（34.7%）患者出现不良预后。入院时营养不良患病率为3.8%，住院2周后为7.5%，这并不能预测3个月后的预后。在2周的住院期间，36例患者（4.7%）出现新发营养不良，在调整混杂因素后，新发营养不良独立预测3个月后的不良预后（比值比1.37，95%置信区间1.03 - 1.83）。
在本研究中，住院期间出现的新发营养不良独立预测急性卒中患者3个月后的不良预后。
