INSERM, U1094, Tropical Neuroepidemiology, Limoges, France; Tropical Neuroepidemiology, Institute of Neuroepidemiology and Tropical Neurology, University of Limoges, UMR_S 1094, Limoges, France; Research Institute of Health Sciences/Centre MURAZ, Bobo-Dioulasso, Burkina Faso; Université Ouaga I Pr Joseph KI-ZERBO, Ouagadougou, Burkina Faso.
INSERM, U1094, Tropical Neuroepidemiology, Limoges, France; Tropical Neuroepidemiology, Institute of Neuroepidemiology and Tropical Neurology, University of Limoges, UMR_S 1094, Limoges, France; Université Ouaga I Pr Joseph KI-ZERBO, Ouagadougou, Burkina Faso; Medicine Department, Souro Sanou University Hospital, Bobo-Dioulasso, Burkina Faso.
Nutrition. 2018 Apr;48:55-60. doi: 10.1016/j.nut.2017.10.022. Epub 2017 Nov 27.
Dysphagia and undernourishment are common in cerebrovascular accident (stroke) patients in developed countries. Despite the dietary transition, there is little information available in Africa on this topic. This study aims to assess the prevalence of undernourishment and dysphagia in stroke patients in two Burkina Faso teaching hospitals at a starting point (D0), on the eighth day, and on the 14th (D14) and to specify factors related to undernourishment at day 14.
The nutritional state of the patients was assessed using body mass index, triceps skinfold thickness, and mid-upper arm circumference. Dysphagia was identified using the Practical Aspiration Screening Schema.
A total of 222 patients were included in the study. From D0 to D14, the prevalence of undernourishment increased from 25.2% to 31.0% and the prevalence of dysphagia decreased from 37.4% to 15.8%. All nutritional criteria worsened. In a multivariate analysis, undernourishment was more present at D14 for women (odds ratio [OR] = 7.01; 95% confidence interval [CI]: 1.51-32.56, P = 0.01) and was less present if weight (OR = 0.69; 95% CI: 0.60-0.79, P = 0.0001) or triceps skinfold thickness (OR = 0.85; 95% CI: 0.74-0.99, P = 0.03) were high at D0.
The prevalence of undernourishment was high at D0 and increased during the monitoring period. It would be advisable to monitor patients' weight and triceps skinfold thickness, to optimize care for women and patients with low weight or triceps skinfold thickness at D0, to monitor dysphagia, and to inform patients, families, and relevant staff of nutritional concerns after a cerebrovascular accident.
在发达国家,吞咽困难和营养不良在脑血管意外(中风)患者中很常见。尽管饮食发生了转变,但在非洲,关于这个主题的信息很少。本研究旨在评估布基纳法索两家教学医院中风患者在起点(D0)、第 8 天(D14)和第 14 天(D14)时营养不良和吞咽困难的患病率,并确定第 14 天营养不良的相关因素。
使用体重指数、三头肌皮褶厚度和中上臂围评估患者的营养状况。使用实用吸入筛查方案识别吞咽困难。
共有 222 名患者纳入研究。从 D0 到 D14,营养不良的患病率从 25.2%增加到 31.0%,吞咽困难的患病率从 37.4%下降到 15.8%。所有营养标准均恶化。在多变量分析中,女性在 D14 时更容易出现营养不良(优势比[OR] = 7.01;95%置信区间[CI]:1.51-32.56,P = 0.01),而体重(OR = 0.69;95% CI:0.60-0.79,P = 0.0001)或三头肌皮褶厚度(OR = 0.85;95% CI:0.74-0.99,P = 0.03)较高时营养不良的情况较少。
D0 时营养不良的患病率较高,并在监测期间增加。建议监测患者的体重和三头肌皮褶厚度,以优化对女性和 D0 时体重或三头肌皮褶厚度较低的患者的护理,监测吞咽困难,并告知患者、家属和相关工作人员中风后的营养问题。