Nutritional status in acute stroke: undernutrition versus overnutrition in different stroke subtypes

Abstract

In the acute stage of stroke, undernourishment was significantly (P=0.000) more prevalent in the ICH group (62%) than in the CI group (25%) or controls (13%). On the other hand obesity was present in 10%, 24% and 17% in patients with ICH, those with CI, and controls, respectively, which was not significantly different (P=0.461). Only abdominal skinfold thickness was significantly greater in patients with CI than in those with ICH or controls. Conclusions - Our results illustrate that undernourishment is prevalent in acute stroke patients, significantly more so in patients with ICH than in those with CI. Stroke patients, especially those with ICH, should receive special nutritional intervention starting immediately after admission.

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

“…The percentage of patients identified as malnourished, at any point after the stroke, based on the authors' primary criteria, ranged from 6.1% 12 to 62%. 1 If the criteria were widened to include the secondary criteria used in 2 studies, the range of estimates broadened from 1.3% 20 to 73%. 21 Clinical evaluations based entirely on subjective criteria were used in 5 studies.…”

“…The reference lists of these articles were hand searched and yielded 3 hits. 1,2,10 Two studies were considered duplicates and subsequently excluded. Finestone et al 2 described and reported the nutritional status of the same group of patients in a previously identified publication.…”

“…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] …”

“…[1][2][3][4][5] Given that many factors could have influenced the precision of the estimates such as differences in patient characteristics and method and timing of nutritional assessment, it is impossible to know which estimate(s) most closely approximate the truth. Establishing a patient's true nutritional state can be a daunting task because there is not a universally accepted definition of malnutrition or a gold standard for nutritional assessment.…”

“…The purpose of this review was to survey the published literature to identify studies in which the nutritional status of patients was assessed in hospital following stroke to: (1) describe the form of nutritional assessment that was used; (2) identify the percentage of subjects identified as malnourished; and (3) establish whether a valid form of nutritional assessment was used.…”