Subjective global assessment of malnutrition and dysphagia effect on the clinical and Para-clinical outcomes in elderly ischemic stroke patients: a community-based study

Abstract

Background Malnutrition as a result of insufficient intake or uptake of nutrition leads to increasing rate of chronic diseases such as stroke. Stroke is one of the most common causes of death in western countries and its increasing trend has attracted lots of attention. In this regard, it seems logical to focus on modifiable risk factors such as nutrition, in order to reduce the resulting complications. Accordingly, this study aimed at evaluating nutrition status of stroke patients to estimate its relationship with clinical outcomes of stroke. Methods In the present cross-sectional study, 349 patients were recruited. Nutrition assessment was performed using Patient-Generated Subjective Global Assessment (PG-SGA). In addition, National Institutes of Health Stroke Scale (NIHSS), modified Rankin Scale (mRS), and biochemical tests were performed. Results Our findings elucidated a significant positive correlation of mRS with PG-SGA and consciousness score, as well as a negative correlation with BMI, calf circumference, mid-arm circumference, and triceps skinfold at admission time (P ≤ 0.002). Moreover, a direct correlation was found between mRS and PG-SGA and consciousness score at discharge time (P ≤ 0.001). In contrast, an inverse correlation was established between mRS and mid-arm circumference (P = 0.02). Furthermore, univariate analysis indicated significant associations between mRS ≥ 3 and age (OR: 1.02; 95%CI: 1.00–1.04), PG-SGA (OR: 1.08; 95%CI: 1.03–1.13), NIHSS (OR: 1.04; 95%CI: 1.02–1.07), dysphagia (OR: 1.69; 95%CI: 1.03–2.77), consciousness (OR: 1.48; 95%CI: 1.07–2.04), and mid-arm circumference (OR: 0.95; 95%CI: 0.90–1.00). In addition, these associations remained significant in multivariate analysis for PG-SGA (OR: 1.07; 95%CI: 1.00–1.13) and NIHSS (OR: 1.04; 95%CI: 1.01–1.07). Conclusion This study revealed a positive correlation between mRS and consciousness status and PG-SGA score, as well as a negative one between mRS and MAC at discharge time.

Development and Validation of a Nomogram for Predicting Nutritional Risk Based on Frailty Scores in Older Stroke Patients

“…Previous research has demonstrated a bidirectional relationship between ADL and nutrition, while the ability to perform daily activities can predict nutritional status, nutrition which, in turn, significantly influences one's daily functioning. A compromised ability to conduct daily tasks might signify challenges related to feeding and other activities, resulting in inadequate nutritional intake and potential deterioration of a patient's nutritional status [ 22 , 23 ]. Furthermore, reduced motor function can impact muscle mass and metabolic rate, elevating nutritional risk.…”

A Meta-analysis of the Correlation Between Nutritional Risk and Prognosis in Stroke Patients Assessed by Different Scales

“…3 articles [9,33,36](1169 cases) used SGA and PG-SGA scale to measure the nutritional status of patients with stroke and analyze the correlation between prognosis and nutritional status. The results of the meta-analysis showed that there was heterogeneity between the study results (I2=99.54%, >50%, and P<0.1 of Q Meta).…”

The Link between Stroke Risk and Orodental Status—A Comprehensive Review

“…Stroke is an acute condition characterized by the sudden loss of blood supply to a region of the brain, causing injury to the cells and tissues [ 19 , 20 , 21 , 22 ]. Stroke is typically divided into ischemic stroke and hemorrhagic stroke ( Figure 2 ).…”