Zhongguo quanke yixue (Feb 2023)
Analysis of Influencing Factors of the Nutritional Status in Stoke Patients Hospitalized at Different Time Points
Abstract
Background Malnutrition is frequently observed in stroke patients. Most of the previous studies focused on their nutritional status at the time of admission, but there is a lack of studies on the nutritional status in different periods of hospitalization. Objective To investigate the influencing factors of nutritional status in stroke patients at different time points (admission, the 7th day and discharge) . Methods The study comprised 177 patients with the diganosis stroke admitted to the Department of Rehabilitation Medicine of the First Affiliated Hospital of Zhengzhou University between January and December 2021. According to the nutritional status, the patients were divided into nutritional normal and malnutrition groups at different time points. General data of the patients were being collected, including gender, age, hypertension, diabetes, post-stroke pneumonia, post-stroke anxiety and depression, obstructive sleep apnea hypoventilation syndrome (OSAHS), history of smoking and alcohol consumption, and mode of nutritional support〔oral feeding only, nasogastric tube only (NGT), intermittent oral to esophageal tube feeding only (IOE), combined parenteral nutrition (PN) 〕. Assessment of patients′ swallowing function using the Water Swallow Test (WST), and the degree of neurological deficits can be evaluated by the National Institutes of Health Stroke Scale (NIHSS). Univariate and multifactorial Logistic regression analyses were used to determine the factors influencing the nutritional status of stroke inpatients at different time points. Results The incidence of malnutrition in stroke patients at admission, the 7th day and discharge were 11.9%, 32.2% and 19.8%, respectively. The rate of malutrition on the 7th day of admission was higher than admission and discharge (P<0.05). At the time of admission, between the normal nutrition group (n=156) and the malnutrition group (n=21) in the age, smoking and drinking history, nutritional support mode, and WST score, there were significantly different (P<0.05). On the 7th day of hospitalization, the normal nutrition group (n=120) was significant differences in age, post-stroke pneumonia, nutritional support mode, WST score and NIHSS score compared with malnutrition group (n=57) (P<0.05). At the time of discharge, the differences were statistically significant in nutrition support mode, WST score and NIHSS score between the normal nutrition group (n=142) and malnutrition group (n=35) (P<0.05). At the time of admission, WST score〔OR=2.118, 95%CI (1.390, 3.226), P<0.001〕was the influencing factor of malnutrition. On the 7th day, age〔OR=1.035, 95%CI (1.001, 1.070), P=0.028〕, combined-PN〔OR=19.206, 95%CI (3.188, 115.707), P=0.001〕and NIHSS score〔OR=1.108, 95%CI (1.029, 1.194), P=0.007〕were influencing malnutrition. Only-NGT〔OR=13.518, 95%CI (1.783, 102.493), P=0.012〕and combined-PN〔OR=18.445, 95%CI (2.870, 118.531), P=0.002〕are the influencing factors at the time of discharge. Conclusion The incidence of malnutrition is higher in stroke patients at admission, the 7th day and discharge. WST score is an influential factor for malnutrition at the time of admission. On the 7th day, the age, PN, and NIHSS score are influencing factors relevant to malnutrition. At the time of discharge, only-NGT and combined-PN are meaningful factors for malnutrition.
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