Malnutrition determined by the patient-generated subjective global assessment is associated with poor outcomes in acute stroke patients

Martineau, J.; Bauer, Judy; Isenring, Elisabeth; Cohen, Sarah

doi:10.1016/j.clnu.2005.08.010

Cited by 158 publications

(127 citation statements)

References 23 publications

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“…Further potential nutritional risk factors included were medications (antipsychotics, antidepressants, and antianxiety/hypnotics) (18), cancer, Parkinson's disease, congestive heart failure and stroke, infections and any psychiatric diagnosis (19,20,21,22), including Alzheimer's disease and other dementia (6).…”

Section: Other Health and Functional Status Indicatorsmentioning

confidence: 99%

Unintended weight loss in the elderly living at home: The aged in home care project (ADHOC)

Sørbye¹,

Schroll

Finne-Soveri³

et al. 2008

The Journal of nutrition, health and aging

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Abstract:Objective: To describe associations between unintended weight loss (UWL) and characteristics of nutritional status. Design: A comparative cross-sectional assessment study at 11 sites in Europe. The target population was a stratified random sample of 4,455 recipients of home care (405 in each random sample from 11 urban areas) aged 65 years and older. Measurements: the Resident Assessment Instrument for Home Care, version 2.0. Epidemiological and medical characteristics of clients and service utilisation were recorded in a standardized, comparative manner. UWL was defined as information of 5% or more weight loss in the last 30 days (or 10% or more in the last 180 days). Results: The final sample consisted of 4,010 persons; 74% were female. The mean ages were 80.9 ± 7.5 years (males) and 82.8 ± 7.3 years (females). No associations were found between single diagnoses and UWL, except for cancer. Cancer patients were excluded from further analyses. Persons with a Cognitive Performance Scale value (CPS) > 3 (impaired) had increased risk of UWL (OR = 2.0) compared with those scoring < 3 (less impaired). Only in the oldest group did we find a significant association between UWL and reduction in ADL and IADL functions, comparing those who scored 3 or less with those who scored more than 3 (disabled). A binary logistic regression model explained 26% of UWL: less than one meal/day, reduced appetite, malnutrition, reduced social activity, experiencing a flare-up of a recurrent or chronic problem, and hospitalisation were important indicators. Conclusion: We recommend a regular comprehensive assessment in home care to identify clients with potential risk factors for weight loss and malnutrition, in particular those discharged from hospital, and those with physical dependency or cognitive problems. This study may provide incentives to create tailored preventive strategies.

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Section: Other Health and Functional Status Indicatorsmentioning

confidence: 99%

Unintended weight loss in the elderly living at home: The aged in home care project (ADHOC)

Sørbye¹,

Schroll

Finne-Soveri³

et al. 2008

The Journal of nutrition, health and aging

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“…14 -16,20 Two trials used modified versions of SGA. 17,19 The details of the original validation studies are presented in Table 2. None of the techniques used in the remaining studies were previously validated.…”

Section: Validity Of Nutritional Assessment Methodsmentioning

confidence: 99%

“…7 Therefore, a total of 18 studies remained for review. [1][2][3][4][5]10,[12][13][14][15][16][17][18][19][20][21][22][23] …”

Section: Literature Reviewedmentioning

confidence: 99%

Which Reported Estimate of the Prevalence of Malnutrition After Stroke Is Valid?

Foley

Salter²,

Robertson³

et al. 2009

Stroke

169

101

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Background and Purpose-The reported prevalence of malnutrition after stroke varies widely, whereas it remains unclear which of the estimates is most accurate. The aim of this review was to explore possible sources of this heterogeneity among studies and to evaluate whether the nutritional assessment techniques used were valid. Methods-A literature search was conducted to identify all studies in which the nutritional state of patients was assessed after inpatient admission for stroke. The percentages of patients identified as malnourished in each study and method of nutritional assessment are reported. For the purposes of this study, an assessment technique was considered valid if at least one form of validity had been demonstrated previously through psychometric evaluation. Results-Eighteen studies meeting inclusion criteria were identified. The reported frequency of malnutrition ranged from 6.1% to 62%. Seventeen different methods of nutritional assessment were used. Four trials used previously validated assessment methods: Subjective Global Assessment, "an informal assessment," and Mini Nutritional Assessment. The nutritional assessment methods used in the remaining studies used had not been validated previously. Conclusions-The

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“…En España, la incidencia acumulada por 100.000 habitantes se ha estimado en 218 (IC95%, 214-221) en varones y 127 (IC95%, 125-128) en mujeres (4). En el momento del ictus, hasta el 20% de los pacientes ya están desnutridos, probablemente debido a su edad avanzada y a la existencia de alguna discapacidad previa, lo que se asocia a peor pronóstico (5). Después del ictus, el estado nutricional se deteriora, generalmente por disfagia y déficits neurológicos que dificultan la alimentación autónoma.…”

Section: Enfermedad Vascular Cerebralunclassified

¿Y después del ictus, qué hacemos para nutrirle?

Pomar¹

2017

Nutr Hosp

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Neurological conditions usually cause altered levels of consciousness or swallowing mechanisms which make artifi cial nutritional support necessary. International guidelines recommend nutritional screening to detect malnutrition in patients with neurological diseases. Dysphagia is a common problem after a stroke, however, it is a treatable pathology, and swallowing rehabilitation allows for improving patients' nutritional status. Awareness of this problem is required among healthcare professionals both for its diagnosis and for the implementation of nutritional intervention measures. Patients should be tested for dysphagia within the fi rst 24 hours of the stroke onset; this swallowing assessment as well as malnutrition screening should never be delayed by more than 72 hours. The present study addresses diagnostic and therapeutic approaches, the indications of the different nutritional treatments available and the transition to oral feeding in patients who have had a stroke episode. ¿Y después del ictus, qué hacemos para nutrirle?How is the patient's nutrition after a stroke? ResumenLas enfermedades neurológicas conllevan, a menudo, alteraciones en el nivel de conciencia o en los mecanismos de la deglución que hacen necesario un soporte nutricional artifi cial. Las guías internacionales recomiendan realizar un cribado de malnutrición a los pacientes con enfermedades neurológicas. La disfagia es un problema frecuente después de un ictus. Sin embargo, la disfagia es una patología tratable y la rehabilitación de la función deglutoria permite mejorar el estado nutricional de los pacientes. Los equipos sanitarios deber estar sensibilizados ante este problema, tanto para su diagnóstico, como para instaurar medidas de intervención nutricional. La presencia de disfagia debería valorarse en las primeras 24 horas tras un ictus y no retrasarse más de 72 horas, así como el cribado de desnutrición. Se revisan el enfoque diagnóstico y terapéutico así como las indicaciones de las distintas modalidades de tratamiento nutricional y la transición a la alimentación oral en el paciente con ictus.

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Malnutrition determined by the patient-generated subjective global assessment is associated with poor outcomes in acute stroke patients

Cited by 158 publications

References 23 publications

Unintended weight loss in the elderly living at home: The aged in home care project (ADHOC)

Unintended weight loss in the elderly living at home: The aged in home care project (ADHOC)

Which Reported Estimate of the Prevalence of Malnutrition After Stroke Is Valid?

¿Y después del ictus, qué hacemos para nutrirle?

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