Association between malnutrition and long-term mortality in older adults with ischemic stroke

Yuan, Kang; Zhu, Shuanggen; Wang, Huaiming; Chen, Jingjing; Zhang, Xiaohao; Xu, Pengfei; Xie, Yi; Zhu, Xinyi; Zhu, Wusheng; Sun, Wen; Xu, Gelin; Liu, Xinfeng

doi:10.1016/j.clnu.2021.04.018

Cited by 58 publications

(73 citation statements)

References 31 publications

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“…Our study did not report a significant association of total cholesterol level with mortality in the univariate analysis. This was also observed in other studies ( Yuan et al, 2021 ), highlighting the importance of variability in total cholesterol level ( Kim et al, 2017 ). Further studies are warranted to comprehensively evaluate the association of total cholesterol level with clinical outcomes in patients undergoing IVT.…”

Section: Discussionsupporting

confidence: 87%

“…Moreover, the incidence of moderate to severe malnutrition risk ranged from 7.0 to 33.7%. The prevalence of moderate to severe malnutrition in this cohort was higher than that previously demonstrated in Third China National Stroke Registry ( Zhang et al, 2021 ) and a hospital-based retrospective study in Japan ( Naito et al, 2020 ), as well as similar to that reported in Nanjing Stroke Registry Program ( Yuan et al, 2021 ). This discrepancy of variation in malnutrition prevalence may be attributed to the difference in nutritional screening tools, timing, and populations.…”

Section: Discussionsupporting

confidence: 86%

“…It has been reported that Malnutrition is associated with poor prognosis in a variety of diseases, such as heart failure, acute coronary syndrome, as well as ischemic stroke ( Amare et al, 2015 ; Raposeiras Roubín et al, 2020 ; Yuan et al, 2021 ). The prevalence of malnutrition risk in stroke patients ranged widely from 6.0 to 62%, according to a systematic review consisting of 18 studies ( Foley et al, 2009 ).…”

Section: Introductionmentioning

confidence: 99%

“…Several objective nutritional tools were performed for evaluating malnutrition risk, including the controlling nutritional status (CONUT) score ( Ignacio de Ulíbarri et al, 2005 ), geriatric nutritional risk index (GNRI) ( Bouillanne et al, 2005 ), and prognostic nutritional index (PNI) ( Buzby et al, 1980 ). Recently, the three malnutrition scores, which can be easily calculated from objective variables, have been validated in predicting the prognosis of cardiovascular diseases and ischemic stroke ( Raposeiras Roubín et al, 2020 ; Yuan et al, 2021 ; Zhang et al, 2021 ). Using the three objective malnutrition indexes, data from Third China National Stroke Registry found that malnutrition risk in ischemic stroke patients was linked to a higher risk of long-term death and major disability ( Zhang et al, 2021 ).…”

Section: Introductionmentioning

confidence: 99%

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Malnutrition and Risk of Mortality in Ischemic Stroke Patients Treated With Intravenous Thrombolysis

Tang

Gong

Guo

et al. 2022

Front. Aging Neurosci.

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Background and PurposeMalnutrition is highly prevalent in ischemic stroke patients. We aimed to investigate whether malnutrition indexes may be useful in predicting mortality at 90 days in ischemic stroke patients treated with intravenous thrombolysis.MethodsWe retrospectively analyzed consecutive patients who underwent thrombolytic therapy at three comprehensive stroke centers. Malnutrition was assessed using the controlling nutritional status (CONUT) score, geriatric nutritional risk index (GNRI), and prognostic nutritional index (PNI).ResultsOf 979 patients (mean age, 66.8 years; males, 63.6%) included in this study, 91 (9.3%; 95% confidence interval [CI]: 8.4–10.2%) died at 3-month follow up. According to the CONUT, GNRI, and PNI scores, 9.9, 33.7, and 7.0% of patients were moderately or severely malnourished, respectively; 64.0% were at least mildly malnourished by at least 1 malnutrition index. In the multivariate regression model after adjusting for potential confounders, malnutrition (severe risk versus normal nutritional status) was significantly associated with an increased risk of mortality for CONUT scores (adjusted odds ratio [OR] 16.16, 95%CI, 7.86-67.11; P < 0.001), GNRI scores (adjusted OR 9.82, 4.10-23.51; P < 0.001) and PNI scores (adjusted OR 12.74, 5.56-29.19; P < 0.001). Similar results were found when the malnutrition scores were analyzed as continuous variables. Adding the three malnutrition indexes to models containing conventional risk factors significantly improved risk reclassification for 3-month mortality.ConclusionOur study showed that malnutrition may be associated with a higher risk of mortality at 3 months in ischemic stroke after intravenous thrombolysis.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionsupporting

confidence: 86%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Malnutrition and Risk of Mortality in Ischemic Stroke Patients Treated With Intravenous Thrombolysis

Tang

Gong

Guo

et al. 2022

Front. Aging Neurosci.

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“…Malnutrition has been well-described as an independent predictor of adverse health-economic outcomes, such as length of stay and mortality [ 28 , 36 , 37 ]. Overall, 3756 of 4311 (87.1%) patients in the cohort survived, while 555 (12.9%) died.…”

Section: Discussionmentioning

confidence: 99%

Malnutrition Increases Hospital Length of Stay and Mortality among Adult Inpatients with COVID-19

et al. 2022

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Background: Malnutrition has been linked to adverse health economic outcomes. There is a paucity of data on malnutrition in patients admitted with COVID-19. Methods: This is a retrospective cohort study consisting of 4311 COVID-19 adult (18 years and older) inpatients at 5 Johns Hopkins-affiliated hospitals between 1 March and 3 December 2020. Malnourishment was identified using the malnutrition universal screening tool (MUST), then confirmed by registered dietitians. Statistics were conducted with SAS v9.4 (Cary, NC, USA) software to examine the effect of malnutrition on mortality and hospital length of stay among COVID-19 inpatient encounters, while accounting for possible covariates in regression analysis predicting mortality or the log-transformed length of stay. Results: COVID-19 patients who were older, male, or had lower BMIs had a higher likelihood of mortality. Patients with malnutrition were 76% more likely to have mortality (p < 0.001) and to have a 105% longer hospital length of stay (p < 0.001). Overall, 12.9% (555/4311) of adult COVID-19 patients were diagnosed with malnutrition and were associated with an 87.9% increase in hospital length of stay (p < 0.001). Conclusions: In a cohort of COVID-19 adult inpatients, malnutrition was associated with a higher likelihood of mortality and increased hospital length of stay.

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Malnutrition on admission increases the in‐hospital mortality and length of stay in elder adults with acute ischemic stroke

Hao

Xia

et al. 2021

Clinical Laboratory Analysis

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Association between malnutrition and long-term mortality in older adults with ischemic stroke

Cited by 58 publications

References 31 publications

Malnutrition and Risk of Mortality in Ischemic Stroke Patients Treated With Intravenous Thrombolysis

Malnutrition and Risk of Mortality in Ischemic Stroke Patients Treated With Intravenous Thrombolysis

Malnutrition Increases Hospital Length of Stay and Mortality among Adult Inpatients with COVID-19

Malnutrition on admission increases the in‐hospital mortality and length of stay in elder adults with acute ischemic stroke

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