Division of Neurology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan.
Department of Pediatric Surgery, Nihon University School of Medicine, Tokyo, Japan.
Ann Nutr Metab. 2021;77(2):116-123. doi: 10.1159/000515212. Epub 2021 May 19.
BACKGROUND/AIMS: Undernutrition is common in patients after acute ischemic stroke (AIS) and predicts poor clinical outcomes. We assessed the relationship between undernutrition and prognosis after AIS.
We retrospectively assessed consecutively hospitalized AIS patients aged ≥65 years. A poor prognosis for patients after AIS was defined as a modified Rankin Scale (mRS) score of ≥3 at discharge. Nutritional status was evaluated based on the degree and risk of undernutrition as determined by the Controlling Nutritional Status (UND-CONUT) and Geriatric Nutritional Risk Index (UNR-GNRI) scores.
Among 218 patients (male, 62.8%; median age, 77 years), 81 had a poor prognosis. A significant correlation was found between UND-CONUT and UNR-GNRI scores (p < 0.001, r = 0.433). Patients with a poor prognosis showed significant undernutrition based on UND-CONUT (p = 0.003) but not on UNR-GNRI (p = 0.218). Patients with undernutrition based on UND-CONUT showed poor outcomes: higher mRS scores at discharge, higher percentages of mRS scores of ≥2 and ≥3, and more complications associated with pneumonia. No significant differences were seen between cases with and without undernutrition risk based on UNR-GNRI.
UND-CONUT appeared to be more useful than UNR-GNRI for predicting the prognosis of elderly patients with AIS at discharge.
背景/目的：急性缺血性脑卒中（AIS）后患者常发生营养不良，且预测临床预后不良。我们评估了 AIS 后营养不良与预后的关系。
我们回顾性评估了连续住院的年龄≥65 岁的 AIS 患者。AIS 后患者预后不良定义为出院时改良 Rankin 量表（mRS）评分≥3 分。营养状况根据 Controlling Nutritional Status（UND-CONUT）和老年营养风险指数（UNR-GNRI）评分确定的营养不良程度和风险进行评估。
在 218 例患者（男性，62.8%；中位年龄，77 岁）中，81 例预后不良。UND-CONUT 和 UNR-GNRI 评分之间存在显著相关性（p<0.001，r=0.433）。预后不良患者根据 UND-CONUT 显示出明显的营养不良（p=0.003），但根据 UNR-GNRI 则不然（p=0.218）。根据 UND-CONUT 存在营养不良的患者预后较差：出院时 mRS 评分较高、mRS 评分≥2 和≥3 的百分比较高、与肺炎相关的并发症较多。根据 UNR-GNRI 有无营养不良风险的病例之间未见显著差异。
与 UNR-GNRI 相比，UND-CONUT 似乎更能预测 AIS 老年患者出院时的预后。
