Department of Clinical Nutrition, Keiju Medical Center and Noto Liaison Council for Cerebral Stroke, Nanao City, Japan.
Department of Rehabilitation Medicine, Yokohama City University Medical Center, Yokohama City, Japan.
Geriatr Gerontol Int. 2018 Sep;18(9):1334-1339. doi: 10.1111/ggi.13467. Epub 2018 Jul 13.
There is no consensus on energy intake in the acute stage and how it relates to improvement in activities of daily living (ADL) in geriatric stroke patients. We examined whether energy intake after admission is related to improvement in ADL and complications.
This retrospective cohort study evaluated the data from stroke inpatients at five acute care hospitals, including the mean daily energy intake during the first week after admission. Patients were categorized into two groups based on their daily energy intake; cases where the energy intake per day reached the basal energy expenditure calculated by the Harris-Benedict equation were designated as the intake energy sufficiency group. Patient characteristics were compared between groups. We assessed ADL using the Functional Independence Measure; a secondary outcome was the presence of complications.
Of the 192 participants (mean age 79.6 ± 7.6 years) included in the study, 131 patients were admitted for cerebral infarction, 58 for intracerebral hemorrhage and three for subarachnoid hemorrhage. Of the two groups, that with an energy sufficiency had a greater gain in total Functional Independence Measure (median 27 and 9, respectively; P = 0.001) and a lower complication rate (6.7% and 26.5%, respectively; P ≤ 0.001). Multivariate analyses showed that energy sufficiency was independently associated with the total Functional Independence Measure gain and complication rate.
Energy intake during the first week after admission affected improvement of ADL and onset of complications during hospitalization in geriatric stroke inpatients. Geriatr Gerontol Int 2018; 18: 1334-1339.
老年脑卒中患者急性期的能量摄入及其与日常生活活动（ADL）改善的关系尚未达成共识。本研究旨在探讨入院后能量摄入与 ADL 改善和并发症的关系。
本回顾性队列研究评估了来自五家急性护理医院的脑卒中住院患者的数据，包括入院后第一周内的平均日能量摄入。根据每日能量摄入将患者分为两组：每日能量摄入达到 Harris-Benedict 方程计算的基础能量消耗的患者被归为摄入能量充足组。比较两组患者的特征。采用功能独立性测量（FIM）评估 ADL；次要结局为并发症的发生。
本研究共纳入 192 名参与者（平均年龄 79.6±7.6 岁），其中 131 名患者因脑梗死入院，58 名因脑出血入院，3 名因蛛网膜下腔出血入院。在这两组患者中，能量充足组的 FIM 总得分增加更大（中位数分别为 27 和 9，P=0.001），并发症发生率更低（分别为 6.7%和 26.5%，P≤0.001）。多变量分析表明，能量充足与 FIM 总得分的增加和并发症发生率独立相关。
入院后第一周的能量摄入影响老年脑卒中患者住院期间 ADL 的改善和并发症的发生。
