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Protein, malnutrition and wasting disorders

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

European Journal of Clinical Nutrition volume 74, pages 796–805 (2020)Cite this article

Subjects

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.

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Acknowledgements

We thank all the patients participated in the study.

Funding

This work was supported by project of the Science Committee in Wenzhou China. (Project number: Y20190561).

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Authors and Affiliations

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

    Zhong-ming Cai, Yan-zhi Wu, Hao-man Chen, Ren-qian Feng, Cheng-wei Liao, Sheng-lie Ye & Zhi-peng Liu

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

    Man-man Zhang & Bei-lei Zhu

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Contributions

ZC performed analyses and drafted the article; BZ and MZ designed the study and critically reviewed the paper; YW, HC, RF, CL, SY and ZL performed epidemiological investigation and data collection. All authors approved the final version of the paper.

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Correspondence to Bei-lei Zhu.

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Co-coressponding authors: Man-man Zhang, Bei-lei Zhu

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Cai, Zm., Wu, Yz., Chen, Hm. et al. Being at risk of malnutrition predicts poor outcomes at 3 months in acute ischemic stroke patients. Eur J Clin Nutr 74, 796–805 (2020). https://doi.org/10.1038/s41430-020-0605-8

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