IRCCS Fondazione Don Carlo Gnocchi ONLUS, 50143 Florence, Italy.
Department of Science and Technology for Humans and the Environment, Università Campus Bio-Medico di Roma, 00128 Rome, Italy.
Nutrients. 2024 Oct 22;16(21):3589. doi: 10.3390/nu16213589.
Stroke survivors frequently encounter malnutrition, adversely impacting clinical outcomes. Nevertheless, malnutrition and food consumption in post-stroke patients have not been frequently assessed, and their correlation with rehabilitation outcomes remains inadequately explored. The objective of this observational study was to evaluate malnutrition at admission in these patients, assess food consumption during a six-week rehabilitation program, and analyze their correlation with rehabilitation outcomes.
Subacute post-stroke patients were evaluated at admission (T0) and after a six-week rehabilitation treatment (T1). At T0, we assessed clinical and demographic characteristics, and we diagnosed malnutrition according to the Global Leadership Initiative on Malnutrition (GLIM) criteria. Weight, BMI, hematochemical parameters, and activities of daily living with the modified Barthel Index (mBI) were evaluated at both T0 and T1; recovery was registered as a change in the mBI (ΔmBI = mBIT1 - mBIT0). Patients' food consumption was recorded through visual plate waste estimation of three meals a day, 5 days a week, for six weeks of hospitalization for rehabilitation.
A total of 109 patients completed the study (51 women, mean age 69 ± 11). According to the GLIM criteria, 105 of these patients were at risk of malnutrition, while 43 were malnourished, with 15 severely malnourished. Malnourished patients wasted more food, with respect to non-malnourished patients, as measured by visual plate waste of total meals (25 ± 17% vs. 15 ± 14%; = 0.001) and reached a lower ΔmBI. A linear regression analysis found a significant correlation between the ΔmBI, the waste of a "second dish", which contained mainly protein, and serum albumin at admission, even after controlling for age.
Malnutrition assessed with the GLIM criteria at admission and food consumption are two important nutritional parameters to evaluate in post-stroke patients hospitalized for rehabilitation due to their association with recovery.
脑卒中幸存者经常面临营养不良问题，这对临床结局产生不利影响。然而，脑卒中后患者的营养不良和食物摄入情况并未得到频繁评估，其与康复结局的相关性也未得到充分探讨。本观察性研究旨在评估这些患者入院时的营养不良情况，评估其在 6 周康复治疗期间的食物摄入量，并分析其与康复结局的相关性。
亚急性期脑卒中患者在入院时（T0）和 6 周康复治疗后（T1）进行评估。在 T0，我们评估了临床和人口统计学特征，并根据全球营养不足倡议（GLIM）标准诊断营养不良。在 T0 和 T1 评估了体重、BMI、血液化学参数和改良巴氏指数（mBI）的日常生活活动能力；康复后通过 mBI 的变化（ΔmBI=mBI T1 - mBI T0）记录恢复情况。通过每天三顿饭、每周五天的视觉餐盘废物估计记录患者住院康复期间的食物摄入量，共记录 6 周。
共有 109 例患者完成了研究（51 例女性，平均年龄 69±11 岁）。根据 GLIM 标准，其中 105 例患者有营养不良风险，43 例患者营养不良，15 例患者严重营养不良。与非营养不良患者相比，营养不良患者每餐的浪费量更多，通过视觉餐盘总餐的浪费量来衡量（25±17%比 15±14%； =0.001），并且达到了较低的ΔmBI。线性回归分析发现，入院时的ΔmBI与“第二道菜”的浪费量（主要含蛋白质）和白蛋白呈显著相关，即使在控制年龄后也是如此。
入院时根据 GLIM 标准评估的营养不良和食物摄入是评估因康复而住院的脑卒中患者的两个重要营养参数，因为它们与康复相关。
