Buoite Stella Alex, Gaio Marina, Furlanis Giovanni, Douglas Pauline, Naccarato Marcello, Manganotti Paolo
Clinical Unit of Neurology, Department of Medicine, Surgery and Health Sciences, University Hospital and Health Services of Trieste, University of Trieste, Trieste, Italy.
Clinical Unit of Neurology, Department of Medicine, Surgery and Health Sciences, University Hospital and Health Services of Trieste, University of Trieste, Trieste, Italy.
J Clin Neurosci. 2019 Apr;62:27-32. doi: 10.1016/j.jocn.2019.01.016. Epub 2019 Jan 14.
Proper hydration and nutrition have been found to be contributing factors to a better recovery in patients after stroke. A better knowledge of factors influencing fluid and energy intake may contribute to a better care of the acute stroke patient. Aim of this study was to describe hydration status, fluid intake, and energy intake of stroke patients during acute hospitalization in a stroke unit. A retrospective descriptive study was conducted in stroke patients admitted to a stroke unit. All patients received neurological evaluation and urinary osmolality (uOsm) measure at admission and discharge. During stroke unit stay patients received a day-by-day diary to record data about beverages, food, and therapy. Water and energy content were then reported based on a national nutritional database. Ninety-five patients were included in the analysis. uOsm did not differ between patients with or without dysphagia, with uOsm > 500 mosm/kg in 58.1% at admission and 57.8% at discharge. Inadequate fluid intake was found in 41.2% of the sample with no difference between groups. Insufficient energy intake was found in 95.6% of the sample, with no patients with dysphagia reaching the minimum suggested amount. Our results suggest that a relevant proportion of stroke patients with and without dysphagia may not improve their hydration status during the first days after admission. Diet and therapy were insufficient to achieve recommended fluid intake and energy intake in a large proportion of patients, suggesting a more careful monitoring of hydration and nutrition needs.
适当的水合作用和营养已被发现是中风患者更好恢复的促成因素。更好地了解影响液体和能量摄入的因素可能有助于更好地护理急性中风患者。本研究的目的是描述中风单元急性住院期间中风患者的水合状态、液体摄入量和能量摄入量。对入住中风单元的中风患者进行了一项回顾性描述性研究。所有患者在入院和出院时均接受神经学评估和尿渗透压（uOsm）测量。在中风单元住院期间，患者每天记录关于饮料、食物和治疗的数据。然后根据国家营养数据库报告水和能量含量。95名患者纳入分析。吞咽困难患者与无吞咽困难患者的uOsm无差异，入院时58.1%的患者uOsm>500 mosm/kg，出院时为57.8%。41.2%的样本存在液体摄入不足，各亚组间无差异。95.6%的样本存在能量摄入不足，吞咽困难患者均未达到建议的最低摄入量。我们的结果表明，相当一部分有或无吞咽困难的中风患者在入院后的头几天可能无法改善其水合状态。饮食和治疗不足以使大部分患者达到推荐的液体摄入量和能量摄入量，这表明需要更仔细地监测水合和营养需求。
