Protein energy supplementation of usual hospital diet did not improve outcomes in inpatients with recent stroke

D'Uva, Cami; Martin, C M De

doi:10.1136/ebn.8.4.116

Cited by 2 publications

(1 citation statement)

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“…Interventions to mitigate the impact of malnutrition in the acute stroke setting have primarily focused on nutrition supplementation or enteral feeding (9,(21)(22)(23)(24)(25)(26)(27) with insufficient evidence to support routine supplementation to improve nutrition intake or outcomes in acute stroke patients (21,22). Early enteral feeding is associated with reduction in risk of death, however it is used primarily in dysphagic patients unable to swallow (28).…”

Section: Introductionmentioning

confidence: 99%

Acute stroke patients not meeting their nutrition requirements: Investigating nutrition within the enriched environment

et al. 2020

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Background/Aims: Malnutrition is common after stroke. We investigated the impact of environmental enrichment strategies on dietary intake and rates of malnutrition in an acute stroke unit. Methods: We performed a before-after study. In standard care, meals were delivered to participants' rooms whilst in the enriched environment, communal meals with assistance were offered and nutritional intake reminders were placed at the patient bedside. Nutrition supplementation was provided to both groups if indicated. Breakfast and lunch meals were directly observed while remaining intake was calculated using food charts. Nutrition requirements were calculated for energy (ratio method), protein (1g/kg) and proportion of requirements met. Malnutrition was assessed using the Subjective Global Assessment and body weight. ANCOVA adjusting for stroke severity was used to determine between group differences. Stepwise multivariable logistic regression was performed to assess predictors of nutritional outcomes, adjusting for intervention group, demographic, clinical and baseline nutritional factors. Results: Neither standard care (n=30, age 76.0yrs ± SD12.8) or enriched environment (n=30, age 76.7yrs ± SD12.1, p=0.84) met daily requirements for energy (70.7% ± SD16.8 vs. 70.7% ± SD17.3, p= 0.94) or protein intake (73.2% ± SD18.6 vs. 69.8% ± SD17.3, p= 0.70). Mean body weight dropped: standard care 0.92kg ± SD2.47 vs. enriched 0.64kg ± SD3.12 (p=0.53) and malnutrition increased: standard care 3.3% to 26.6% vs. enriched 6.6% to 13.3% (p=0.07). Predictors of malnutrition on discharge in logistic regression models were: length of stay (p<0.01) and protein (p<0.01) or energy intake (p=0.02).

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