Undernourished stroke patients may have more complications, worse outcomes

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Public release date: 14-Jan-2008

http://www.eurekalert.org/pub_releases/2008-01/jaaj-usp011008.php

Contact: Dong-Wha Kang

dwkang@...

JAMA and Archives Journals

Undernourished stroke patients may have more complications, worse outcomes

Patients who are undernourished when they enter the hospital with an

acute ischemic stroke—the most common type of stroke, in which blood

flow to the brain is blocked—are likely to remain undernourished in the

hospital and may have worse clinical outcomes, according to a report in

the January issue of Archives of Neurology, one of the JAMA/Archives

journals.

“Although undernutrition [a deficiency in overall calories or one or

more nutrients] is common in medical, geriatric and stroke patients, its

treatment has received little attention,” the authors write as

background information in the article. “Because undernutrition may

influence clinical outcomes, it is important to assess nutritional

status and treat undernutrition particularly during acute stage of stroke.”

Sung-Hee Yoo, R.N., M.S., and colleagues at the University of Ulsan

College of Medicine, Seoul, Korea, studied 131 acute ischemic stroke

patients who underwent assessments of their nutritional status within 24

hours of hospital admission and again one week after their symptoms

began. Complications were assessed immediately after admission to the

hospital and continuously until patients left the hospital or

transferred to a rehabilitation unit. Clinical outcomes were measured

three months later.

Of the patients, 16 (12.2 percent) were insufficiently nourished when

they were admitted to the hospital and 26 (19.8 percent) were

undernourished after one week. Undernutrition at hospital admission was

associated with undernutrition one week later and complications

following the stroke, while undernutrition at one week predicted poor

outcomes after three months.

“These results suggest that patients undernourished at admission do not

recover well with general hospital diets and are more likely to have

poststroke complications and that undernourished patients during

hospitalization are more likely to develop poor functional outcomes,”

the authors write.

“Strategic nutritional support, particularly in patients with baseline

undernutrition, may improve clinical outcomes after acute ischemic

stroke,” they conclude.

(Arch Neurol. 2008;65[1]:39-43. Available pre-embargo to the media at

www.jamamedia.org.)

Editor’s Note: This study was supported by a grant from the Korean

Ministry of Health and Welfare, a grant from the Korea Health 21 R & D

Project, Ministry of Health and Welfare, Republic of Korea, and a grant

from the Brain Research Center of the 21st Century Frontier Research

Program funded by the Ministry of Science and Technology of Korea.

Please see the article for additional information, including other

authors, author contributions and affiliations, financial disclosures,

funding and support, etc.

Editorial: Nutritional Support Could Improve Recovery Following Stroke

“The undernourished state may represent another modifiable physiological

risk factor, like hyperglycemia and fever, that when actively treated

leads to improved outcomes,” write Neeraj Badjatia, M.D., and

S. V. Elkind, M.D., M.S., of the Columbia University Medical Center, New

York, in an accompanying editorial.

“This article is the latest in a series of studies representing current

thinking about the potential value of nutritional support for stroke

patients in the acute care setting,” they continue. “Providing adequate

caloric intake early in the course after ischemic stroke may now be seen

as a therapeutic intervention used to minimize disease severity, reduce

complications and favorably affect patient outcomes. In the end, factors

related to overall amount, content, route and timing may determine

whether nutritional support improves outcomes or is ineffective.”

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(Arch Neurol. 2008;65[1]:15-16.

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