The Impact of Undernutrition Risk on Rehabilitation Outcomes in Ischemic Stroke Survivors: A Hospital-Based Study

There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

Abstract

Patients experiencing a cerebrovascular event are vulnerable to declining nutritional status, hindering rehabilitation. This study aims to analyze the association between malnutrition risk and hospital rehabilitation indicators in ischemic stroke survivors (ISS). This analytical study examined medical records of 160 adult patients (69.3 ± 13 years). Undernutrition risk (UR; independent variable) and rehabilitation indicators (dependent variables) like hospital stay, clinical outcome, functionality, stroke severity, food intake, mobility (bedridden), mechanical ventilation, and enteral nutrition were assessed. Data were dichotomized, and the chi-square test identified associations (p ≤ 0.05), followed by Poisson regression for prevalence ratios. Patients at UR had 2-fold higher risk of death (95% confidence interval [CI], 0.99–4.79), 1.8-fold higher risk of high stroke severity (95% CI, 1.06–3.11), 76% higher chance of being bedridden (95% CI, 1.28–2.44), and 3-fold higher risk of mechanical ventilation (95% CI, 1.20–9.52). UR in hospitalized ISS is associated with deteriorating rehabilitation indicators, including mobility, decreased food intake, mechanical ventilation use, and neurological deficit, indicating an increased mortality risk post-stroke.

Highlights

• Ischemic stroke survivors (ISS) at undernutrition risk (UR) are more likely to be bedridden.
• UR exacerbates neurological deficits in stroke survivors.
• ISS facing UR have a higher mortality rate.

Related collections

Most cited references 33

Record: found
Abstract: found
Article: found

Is Open Access

Global, regional, and national burden of stroke, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016

Catherine Owens Johnson, Minh Tri Nguyen, Gregory A Roth … (2019)

Summary Background Stroke is a leading cause of mortality and disability worldwide and the economic costs of treatment and post-stroke care are substantial. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) provides a systematic, comparable method of quantifying health loss by disease, age, sex, year, and location to provide information to health systems and policy makers on more than 300 causes of disease and injury, including stroke. The results presented here are the estimates of burden due to overall stroke and ischaemic and haemorrhagic stroke from GBD 2016. Methods We report estimates and corresponding uncertainty intervals (UIs), from 1990 to 2016, for incidence, prevalence, deaths, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs). DALYs were generated by summing YLLs and YLDs. Cause-specific mortality was estimated using an ensemble modelling process with vital registration and verbal autopsy data as inputs. Non-fatal estimates were generated using Bayesian meta-regression incorporating data from registries, scientific literature, administrative records, and surveys. The Socio-demographic Index (SDI), a summary indicator generated using educational attainment, lagged distributed income, and total fertility rate, was used to group countries into quintiles. Findings In 2016, there were 5·5 million (95% UI 5·3 to 5·7) deaths and 116·4 million (111·4 to 121·4) DALYs due to stroke. The global age-standardised mortality rate decreased by 36·2% (−39·3 to −33·6) from 1990 to 2016, with decreases in all SDI quintiles. Over the same period, the global age-standardised DALY rate declined by 34·2% (−37·2 to −31·5), also with decreases in all SDI quintiles. There were 13·7 million (12·7 to 14·7) new stroke cases in 2016. Global age-standardised incidence declined by 8·1% (−10·7 to −5·5) from 1990 to 2016 and decreased in all SDI quintiles except the middle SDI group. There were 80·1 million (74·1 to 86·3) prevalent cases of stroke globally in 2016; 41·1 million (38·0 to 44·3) in women and 39·0 million (36·1 to 42·1) in men. Interpretation Although age-standardised mortality rates have decreased sharply from 1990 to 2016, the decrease in age-standardised incidence has been less steep, indicating that the burden of stroke is likely to remain high. Planned updates to future GBD iterations include generating separate estimates for subarachnoid haemorrhage and intracerebral haemorrhage, generating estimates of transient ischaemic attack, and including atrial fibrillation as a risk factor. Funding Bill & Melinda Gates Foundation

0 comments Cited 1132 times – based on 0 reviews      Review now

Record: found
Abstract: found
Article: not found

Sugar for the brain: the role of glucose in physiological and pathological brain function.

Philipp Mergenthaler, Ute Lindauer, Gerald Dienel … (2014)

The mammalian brain depends upon glucose as its main source of energy, and tight regulation of glucose metabolism is critical for brain physiology. Consistent with its critical role for physiological brain function, disruption of normal glucose metabolism as well as its interdependence with cell death pathways forms the pathophysiological basis for many brain disorders. Here, we review recent advances in understanding how glucose metabolism sustains basic brain physiology. We synthesize these findings to form a comprehensive picture of the cooperation required between different systems and cell types, and the specific breakdowns in this cooperation that lead to disease. Copyright © 2013 Elsevier Ltd. All rights reserved.

0 comments Cited 561 times – based on 0 reviews      Review now

Record: found
Abstract: found
Article: not found

Nutritional risk screening (NRS 2002): a new method based on an analysis of controlled clinical trials.

Jens Kondrup, Henrik Rasmussen, Ole Hamberg … (2003)

A system for screening of nutritional risk is described. It is based on the concept that nutritional support is indicated in patients who are severely ill with increased nutritional requirements, or who are severely undernourished, or who have certain degrees of severity of disease in combination with certain degrees of undernutrition. Degrees of severity of disease and undernutrition were defined as absent, mild, moderate or severe from data sets in a selected number of randomized controlled trials (RCTs) and converted to a numeric score. After completion, the screening system was validated against all published RCTs known to us of nutritional support vs spontaneous intake to investigate whether the screening system could distinguish between trials with a positive outcome and trials with no effect on outcome. The total number of randomized trials identified was 128. In each trial, the group of patients was classified with respect to nutritional status and severity of disease, and it was determined whether the effect of nutritional intervention on clinical outcome was positive or absent. Among 75 studies of patients classified as being nutritionally at-risk, 43 showed a positive effect of nutritional support on clinical outcome. Among 53 studies of patients not considered to be nutritionally at-risk, 14 showed a positive effect (P=0.0006). This corresponded to a likelihood ratio (true positive/false positive) of 1.7 (95% CI: 2.3-1.2). For 71 studies of parenteral nutrition, the likelihood ratio was 1.4 (1.9-1.0), and for 56 studies of enteral or oral nutrition the likelihood ratio was 2.9 (5.9-1.4). The screening system appears to be able to distinguish between trials with a positive effect vs no effect, and it can therefore probably also identify patients who are likely to benefit from nutritional support.

0 comments Cited 352 times – based on 0 reviews      Review now

All references

Author and article information

Journal

Journal ID (nlm-ta): Brain Neurorehabil

Journal ID (iso-abbrev): Brain Neurorehabil

Journal ID (publisher-id): BN

Title: Brain & NeuroRehabilitation

Publisher: Korean Society for Neurorehabilitation

ISSN (Print): 1976-8753

ISSN (Electronic): 2383-9910

Publication date Collection: March 2024

Publication date (Electronic): 26 February 2024

Volume: 17

Issue: 1

Electronic Location Identifier: e7

Affiliations

[1 ]Research Group in Physiology and Physical Activity, University Pitágoras UNOPAR Anhanguera, Londrina, Brazil.

[2 ]Department of Medicine, Pontifical Catholic University, Londrina, Brazil.

[3 ]Irmandade Santa Casa de Londrina (ISCAL), Londrina, Brazil.

[4 ]Research Laboratory in Muscular System and Physical Exercise, University Pitágoras UNOPAR Anhanguera, Londrina, Brazil.

Author notes

Correspondence to Juliano Casonatto. Research Group in Physiology and Physical Activity, University Pitágoras UNOPAR Anhanguera, 591 Marselha, St –Jd. Piza, Londrina 86041-140, Brazil. juliano2608@ 123456hotmail.com

Author information

Daniela Figueiredo Corrêa Pereira https://orcid.org/0009-0000-6705-5127

Karen Barros Parron Fernandes https://orcid.org/0000-0002-1276-4900

Andreo Fernando Aguiar https://orcid.org/0000-0003-3337-2444

Juliano Casonatto https://orcid.org/0000-0001-5397-5694

Article

DOI: 10.12786/bn.2024.17.e7

PMC ID: 10990841

PubMed ID: 38585033

SO-VID: 1cab19f3-79f6-4bfc-a1a9-7ba1ce5bab43

License:

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( https://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

History

Date received : 06 November 2023

Date revision received : 02 February 2024

Date accepted : 07 February 2024

Comments

Comment on this article

Cited by 1

Nutritional status in subacute post-stroke patients undergoing rehabilitation treatment: a protocol for a prospective observational study
Authors: Mariacristina Siotto, Carola Cocco, Alessandro Guerrini …

See all cited by

Most referenced authors 610

See all reference authors