Clinical Interventions in Aging (Jan 2024)

Predictive Value of Nutritional Risk for All-Cause Death and Functional Outcomes in Chinese Elderly Patients with Acute Stroke: A 3-Year Follow-Up Study

  • Cong WJ,
  • Liu ZP,
  • Liang YX,
  • Ye SL,
  • Cai ZM,
  • Chen HM,
  • Liao CW,
  • Lin QL,
  • Feng RQ,
  • Zhou XD,
  • Wu YZ,
  • Sun LQ,
  • Huang XR,
  • Zhang MM,
  • Huang GQ,
  • Zhu BL

Journal volume & issue
Vol. Volume 19
pp. 109 – 118

Abstract

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Wen-Jie Cong,1,* Zhi-Peng Liu,2,* Yi-Xin Liang,2 Sheng-Lie Ye,2 Zhong-Ming Cai,2 Hao-Man Chen,2 Cheng-Wei Liao,2 Qun-Li Lin,3 Ren-Qian Feng,2 Xu-Dong Zhou,4 Yan-Zhi Wu,2 Le-Qiu Sun,5 Xue-Rong Huang,6 Man-Man Zhang,7 Gui-Qian Huang,8 Bei-Lei Zhu7 1Department of Acupuncture and Physiotherapy, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, People’s Republic of China; 2The First Clinical School, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, People’s Republic of China; 3Department of Neurology, Yongjia People’s Hospital, Wenzhou, Zhejiang, People’s Republic of China; 4Department of Neurology, Pingyang People’s Hospital, Wenzhou, Zhejiang, People’s Republic of China; 5Department of Neurology, Affiliated Yueqing Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, People’s Republic of China; 6Department of Neurology, Ruian People’s Hospital, Wenzhou, Zhejiang, People’s Republic of China; 7Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University Wenzhou Zhejiang People’s Republic of China; 8School of Mental Health, Wenzhou Medical University, Wenzhou, People’s Republic of China*These authors contributed equally to this workCorrespondence: Bei-Lei Zhu, Tel +86 13567896076, Email [email protected]: To explore the predictive value of nutritional risk for all-cause death and functional outcomes among elderly acute stroke patients.Patients and Methods: A total of 479 elderly acute stroke patients were enrolled in this study. The nutritional risk of patients was screened by the GNRI and NRS-2002. The primary outcome was all-cause death, and the secondary outcome was poor prognosis defined as a modified Rankin Scale (mRS) score ≥ 3.Results: Based on the NRS-2002, patients with nutritional risk had a higher risk of all-cause death at 3 months (adjusted OR: 3.642, 95% CI 1.046~12.689) and at 3 years (adjusted OR: 2.266, 95% CI 1.259~4.076) and a higher risk of adverse functional outcomes at 3 months (adjusted OR: 2.748, 95% CI 1.518~4.972. Based on the GNRI, compared to those without nutritional risk, patients with mild malnutrition also had a higher risk of all-cause death at 3 months (adjusted OR: 7.186, 95% CI 1.550~33.315) and at 3 years (adjusted OR: 2.255, 95% CI 1.211~4.199) and a higher risk of adverse functional outcomes at 3 months (adjusted OR: 1.947, 95% CI 1.030~3.680), so patients with moderate and severe malnutrition had a higher risk of all-cause death at 3 months (adjusted OR: 6.535, 95% CI 1.380~30.945) and at 3 years (adjusted OR: 2.498, 95% CI 1.301~4.799) and a higher risk of adverse functional outcomes at 3 months (adjusted OR: 2.213, 95% CI 1.144~4.279).Conclusion: Nutritional risk increases the risk of poor short-term and long-term outcomes in elderly patients with acute stroke. For elderly stroke patients, we should pay attention to early nutritional risk screening, and effective intervention should be provided to improve the prognosis of such patients.Keywords: acute stroke, malnutrition, nutritional screening, all-cause death, GNRI, NRS-2002

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