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营养不良及其相关因素在伴有吞咽困难的急性和亚急性脑卒中患者中的研究

Malnutrition and Associated Factors in Acute and Subacute Stroke Patients with Dysphagia.

机构信息

Department of Rehabilitation Medicine, Gyeongsang National University College of Medicine and Gyeongsang National University Changwon Hospital, Changwon 51472, Republic of Korea.

Department of Rehabilitation Medicine, Gyeongsang National University College of Medicine and Gyeongsang National University Hospital, Institute of Medical Science, Gyeongsang National University, Jinju 52727, Republic of Korea.

出版信息

Nutrients. 2023 Aug 26;15(17):3739. doi: 10.3390/nu15173739.

Abstract

Most patients with stroke suffer from complications and these include dysphagia. Dysphagia can cause malnutrition, and malnutrition affects prognosis and recovery. However, there is a lack of accurate studies on the nutritional status of stroke patients with dysphagia and its associated factors in different phases of stroke. This study retrospectively investigated 620 stroke patients who underwent a videofluoroscopic swallowing study (VFSS) due to dysphagia, from March 2018 to February 2021. The study aimed to evaluate the nutritional state and associated factors of malnutrition in acute and subacute stroke patients with dysphagia. Serum albumin and percentage of current weight to ideal weight were used to determine nutritional status. Malnutrition was observed in 58.9 and 78.9% of acute and subacute stroke patients. Exact logistic regression analysis revealed that old age and high penetration-aspiration scale score were significantly associated factors for malnutrition in patients with acute stroke. Old age, stroke history, bilateral hemiplegia, high modified Rankin score, low Korean Mini-Mental State Examination, pneumonia, and high functional dysphagia score were significantly associated factors for malnutrition in patients with subacute stroke. Patients with these associated factors in each phase of stroke require active nutritional assessment and care to decrease the risk of malnutrition.

摘要

大多数脑卒中患者会出现并发症,其中包括吞咽困难。吞咽困难可导致营养不良,而营养不良会影响预后和恢复。然而,目前缺乏针对不同脑卒中阶段伴吞咽困难患者的营养状况及其相关因素的精确研究。本研究回顾性调查了 2018 年 3 月至 2021 年 2 月因吞咽困难接受视频透视吞咽检查(VFSS)的 620 例脑卒中患者。本研究旨在评估伴有吞咽困难的急性和亚急性脑卒中患者营养不良的营养状况和相关因素。血清白蛋白和目前体重与理想体重的百分比用于确定营养状况。急性和亚急性脑卒中患者中分别有 58.9%和 78.9%存在营养不良。确切的逻辑回归分析显示,高龄和高渗透-吸入量表评分是急性脑卒中患者营养不良的显著相关因素。高龄、脑卒中史、双侧偏瘫、改良 Rankin 评分低、韩国简易精神状态检查低、肺炎和功能性吞咽困难评分高是亚急性脑卒中患者营养不良的显著相关因素。在脑卒中的每个阶段,具有这些相关因素的患者需要进行积极的营养评估和护理,以降低营养不良的风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/142a/10489833/dbd33609750b/nutrients-15-03739-g001.jpg

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