急性缺血性脑卒中患者的营养状况控制评分及与营养不良相关的危险因素
The controlling nutritional status score and risk factors associated with malnutrition in patients with acute ischemic stroke.
作者信息
Chen Yuanyuan, Yang Hongyan, Lan Meijuan, Wei Hui, Chen Yanqin
机构信息
Nursing Department, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China.
出版信息
Front Neurol. 2023 Mar 9;14:1067706. doi: 10.3389/fneur.2023.1067706. eCollection 2023.
OBJECTIVES
Malnutrition is an independent risk factor for poor outcomes in patients who suffered an acute ischemic stroke (AIS). The controlling nutritional status (CONUT) score can provide information for nutritional management in AIS patients. However, the risk factors associated with the CONUT score have not been established to date. Therefore, in this study, we aimed to investigate the CONUT score of patients with AIS and explore the potential risk factors associated with it.
METHODS
We conducted a retrospective review of the data from consecutive AIS patients who were recruited in the CIRCLE study. Within 2 days of admission, we gathered the CONUT score, the Nutritional Risk Screening 2002, the Modified Rankin Scale, the National Institutes of Health Neurological Deficit Score (NIHSS), and demographic data from medical records. We used chi-squared tests to examine admission, and a logistic regression analysis was performed to explore the risk factors associated with CONUT in patients with AIS.
RESULTS
A total of 231 patients with AIS participated in the study, with a mean age of 62.32 ± 13.0 years and a mean NIHSS of 6.77 ± 3.8. Of these patients, 41(17.7%) had hyperlipidemia. In terms of nutritional assessment, 137(59.3%) patients with AIS had high CONUT scores, 86(37.2%) patients with AIS had low or high BMI, and 117(50.6%) patients with AIS had NRS-2002 scores below 3. The chi-squared tests showed that age, NIHSS, body mass index (BMI), and hyperlipidemia were associated with the CONUT score ( < 0.05). The logistic regression analysis showed that low NIHSS scores (OR = 0.055 95% CI: 0.003-0.893), younger age (OR = 0.159 95% CI: 0.054-0.469), and hyperlipidemia (OR = 0.303 95% CI: 0.141-0.648) were independently associated with lower CONUT scores ( < 0.05), whereas BMI was not found to be independently associated with the CONUT.
CONCLUSIONS
More than half of the patients with AIS were at risk of malnutrition, with age and neurological deficits being identified as risk factors for nutritional control. Hyperlipidemia was found to be a protective factor of the CONUT, while NRS-2002 and BMI did not affect the nutritional control in patients with AIS.
目的
营养不良是急性缺血性卒中（AIS）患者预后不良的独立危险因素。控制营养状况（CONUT）评分可为AIS患者的营养管理提供信息。然而，迄今为止，与CONUT评分相关的危险因素尚未明确。因此，在本研究中，我们旨在调查AIS患者的CONUT评分，并探索与之相关的潜在危险因素。
方法
我们对CIRCLE研究中连续纳入的AIS患者的数据进行了回顾性分析。入院2天内，我们从病历中收集了CONUT评分、营养风险筛查2002、改良Rankin量表、美国国立卫生研究院神经功能缺损评分（NIHSS）以及人口统计学数据。我们使用卡方检验来检查入院情况，并进行逻辑回归分析以探索AIS患者中与CONUT相关的危险因素。
结果
共有231例AIS患者参与了本研究，平均年龄为62.32±13.0岁，平均NIHSS评分为6.77±3.8。在这些患者中，41例（17.7%）患有高脂血症。在营养评估方面，137例（59.3%）AIS患者的CONUT评分较高，86例（37.2%）AIS患者的BMI较低或较高，117例（50.6%）AIS患者的NRS - 2002评分低于3分。卡方检验显示，年龄、NIHSS、体重指数（BMI）和高脂血症与CONUT评分相关（P<0.05）。逻辑回归分析显示，较低的NIHSS评分（OR = 0.055，95%CI：0.003 - 0.893）、较年轻的年龄（OR = 0.159，95%CI：0.054 - 0.469）和高脂血症（OR = 0.303，95%CI：0.141 - 0.648）与较低的CONUT评分独立相关（P<0.05），而未发现BMI与CONUT独立相关。
结论
超过一半的AIS患者存在营养不良风险，年龄和神经功能缺损被确定为营养控制的危险因素。高脂血症被发现是CONUT的保护因素，而NRS - 2002和BMI对AIS患者的营养控制没有影响。
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