The Assessment of the Risk of Malnutrition (Undernutrition) in Stroke Patients

Abstract

Malnutrition is common in stroke patients, as it is associated with neurological and cognitive impairment as well as clinical outcomes. Nutritional screening is a process with which to categorize the risk of malnutrition (i.e., nutritional risk) based on validated tools/procedures, which need to be rapid, simple, cost-effective, and reliable in the clinical setting. This review focuses on the tools/procedures used in stroke patients to assess nutritional risk, with a particular focus on their relationships with patients’ clinical characteristics and outcomes. Different screening tools/procedures have been used in stroke patients, which have shown varying prevalence in terms of nutritional risk (higher in rehabilitation units) and significant relationships with clinical outcomes in the short- and long term, such as infection, disability, and mortality. Indeed, there have been few attempts to compare the usefulness and reliability of the different tools/procedures. More evidence is needed to identify appropriate approaches to assessing nutritional risk among stroke patients in the acute and sub-acute phase of disease or during rehabilitation; to evaluate the impact of nutritional treatment on the risk of malnutrition during hospital stay or rehabilitation unit; and to include nutritional screening in well-defined nutritional care protocols.

Clinical application of HALP score to predict early neurological deterioration in elderly acute cerebral infarction patients

“…In addition, albumin re ects the severity of in ammation and disease in acute illness [34] . All the above studies con rmed that in ammatory response and nutritional status are associated with the prognosis of stroke patients.…”

Nutrition in Post-Stroke Subjects during Rehabilitation

“…Finally, the review of Di Vincenzo and colleagues [6] highlights an important problem which summarizes the aim of this Special Issue: malnutrition is a widespread problem in post-stroke patients undergoing rehabilitation, and it can be assumed that little effort has been made to identify a well-defined nutritional care protocol. Nutritional risk assessments in both the acute and subacute phases of stroke are differentiated, and few attempts have been made to compare the different tools/procedures in terms of usefulness and reliability.…”

“…Nutritional risk assessments in both the acute and subacute phases of stroke are differentiated, and few attempts have been made to compare the different tools/procedures in terms of usefulness and reliability. Moreover, we are still far from identifying the most appropriate and well-defined nutritional screening procedures, which should be quick, simple, cost-effective, and reliable in clinical settings [6].…”

Association between the initial physical activity and functional recovery after 1 month of inpatient rehabilitation for subacute stroke: stratified analysis by nutritional status

“…Malnutrition is defined as a state resulting from a lack of nutrient intake or uptake, leading to decreased fatfree mass, body cell mass, and impaired clinical outcomes [12]. Previous studies have revealed that malnutrition in patients with stroke is associated with mortality, a higher risk of poor functional outcomes, and infection [11,[13][14][15][16]. The combination of malnutrition and increased energy requirements due to elevated physical activity levels may cause a negative energy balance and exacerbate malnutrition symptoms.…”

“…The association between physical activity and functional recovery may vary depending on the presence or absence of malnutrition, which is a common complication of stroke [11]. Malnutrition is defined as a state resulting from a lack of nutrient intake or uptake, leading to decreased fat-free mass, body cell mass, and impaired clinical outcomes [12].…”