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患有营养不良风险的急性缺血性脑卒中患者在 3 个月时预后不良。

Being at risk of malnutrition predicts poor outcomes at 3 months in acute ischemic stroke patients.

机构信息

Department of Medicine, First Clinical Medical School, Wenzhou Medical University, Wenzhou, China.

Department of Neurology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.

出版信息

Eur J Clin Nutr. 2020 May;74(5):796-805. doi: 10.1038/s41430-020-0605-8. Epub 2020 Mar 17.

Abstract

BACKGROUND

Malnutrition is confirmed to be associated with poor outcomes in stroke patients. The present study aimed to confirm that being at risk of malnutrition assessed by Nutritional Risk Screening Tool 2002 (NRS-2002) and the Controlling Nutritional Status (CONUT) score predicts poor outcomes at 3 months in acute ischemic stroke (AIS) patients.

METHODS

In total, 682 patients with AIS were recruited within 7 days of stroke onset consecutively and 110 were dropped out. They were screened for risk of malnutrition using NRS-2002 and the CONUT score. The primary outcome is the follow-up modified Rankin Scale (mRS) score. Poor outcomes were defined as an (mRS) score ≥ 3 at 3 months post discharge.

RESULTS

There was a significant difference in the mRS score at 3 months between patients at risk of malnutrition compared to those not at risk assessed by NRS-2002(P < 0.001) and CONUT (P = 0.011). The logistic regression model showed that the risk of malnourishment (according to NRS-2002), low risk of malnourishment (according to CONUT), and the moderate-to-severe risk of malnourishment (according to CONUT) were associated with higher risk of poor outcomes at 3 months (P < 0.001, P = 0.033, and P = 0.007). The multivariate logistic regression model (adjusted for confounding factors) demonstrated that the risk of malnourishment, according to the NRS-2002, was associated with the increasing risk of poor outcomes at 3 months (odds ratio = 2.31; 95% CI: 1.24-4.30; P = 0.008).

CONCLUSIONS

The risk of malnutrition assessed by NRS-2002 and CONUT can predict poor outcomes at 3 months in AIS patients. NRS-2002 is superior to CONUT in predicting poor outcomes at 3 months.

摘要

背景

营养不良已被证实与脑卒中患者的不良预后相关。本研究旨在确认,营养风险筛查 2002 工具(NRS-2002)和控制营养状况(CONUT)评分评估的营养不良风险与急性缺血性脑卒中(AIS)患者 3 个月时的不良预后相关。

方法

共连续纳入 682 例发病 7 天内的 AIS 患者,其中 110 例脱落。使用 NRS-2002 和 CONUT 评分筛查营养不良风险。主要结局为随访改良 Rankin 量表(mRS)评分。预后不良定义为出院后 3 个月 mRS 评分≥3 分。

结果

与 NRS-2002 评估的无营养不良风险患者相比,有营养不良风险的患者在 3 个月时 mRS 评分差异有统计学意义(P<0.001),与 CONUT 评分的差异也有统计学意义(P=0.011)。Logistic 回归模型显示,根据 NRS-2002 评估的营养不良风险、CONUT 评估的低营养不良风险和 CONUT 评估的中重度营养不良风险与 3 个月时不良预后风险较高相关(P<0.001、P=0.033 和 P=0.007)。多变量 Logistic 回归模型(调整混杂因素)表明,根据 NRS-2002 评估的营养不良风险与 3 个月时不良预后风险增加相关(比值比=2.31;95%可信区间:1.24-4.30;P=0.008)。

结论

NRS-2002 和 CONUT 评估的营养不良风险可预测 AIS 患者 3 个月时的不良预后。NRS-2002 在预测 3 个月时的不良预后方面优于 CONUT。

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