Association between malnutrition and long-term mortality in older adults with ischemic stroke
Association between malnutrition and long-term mortality in older adults with ischemic stroke
复制标题
患有缺血性卒中的老年人营养不良与长期死亡率之间的关系
DOI：
10.1016/j.clnu.2021.04.018
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发表时间：
2021-05-01
影响因子：
6.3
通讯作者：
Liu, Xinfeng
中科院分区：
文献类型：
--
作者：
Yuan, Kang;Zhu, Shuanggen;Liu, Xinfeng
背景与目的：营养不良与不同疾病的预后不良有关。本研究旨在调查营养不良与中国老年缺血性stroke.Methods的长期死亡率的关系：我们从南京卒中登记项目中选择了年龄≥ 65岁的首次缺血性卒中患者。营养不良分别根据控制营养状况评分（CONUT）、老年营养风险指数（GNRI）和预后营养指数评分（PNI）进行定义。多变量考克斯比例风险回归和竞争风险回归进行探讨营养不良和老年人缺血性stroke.Results的死亡风险之间的关系：在1065例入组患者中，60.5%，46.7%和30.6%的患者营养不良根据CONUT，GNRI和PNI评分。在中位随访4.74（3.73-5.82）年期间，205例（19.2%）患者死亡。在多变量分析中，营养不良（严重风险与正常营养）与CONUT的死亡风险显著增加相关。（校正风险比[HR] 4.615，95%置信区间[CI] 1.373-15.514，P = 0.013），GNRI（校正HR 3.641，95%CI 1.924-6.891，P < 0.001）和PNI评分（校正HR 1.587，95%CI 1.096-2.297，P = 0.014）。此外，增加营养不良指数的models适度提高了mortals.Conclusions的预测能力：我们的研究表明，营养不良是非常普遍的老年中国成人缺血性中风，并与死亡率增加。需要进一步的研究来评估营养管理在这些患者中的疗效。(c)2021爱思唯尔有限公司和欧洲临床营养与代谢学会。All rights reserved.
Background & aims: Malnutrition is associated with poor prognosis of different diseases. This study aimed to investigate the association of malnutrition with long-term mortality of older adults with ischemic stroke in China.Methods: We selected patients aged >= 65 years with first-ever ischemic stroke from the Nanjing Stroke Registry Program. Malnutrition was defined according to the controlling nutritional status score (CONUT), the geriatric nutritional risk index (GNRI), and the prognostic nutritional index score (PNI), respectively. Multivariable Cox proportional hazards regressions and competing risk regressions were performed to explore the relationship between malnutrition and the risk of mortality in older adults with ischemic stroke.Results: Among 1065 enrolled patients, 60.5%, 46.7%, and 30.6% of patients were malnourished according to CONUT, GNRI, and PNI score. During a median follow-up of 4.74 (3.73-5.82) years, 205 (19.2%) patients died. In multivariate analysis, malnutrition (severe risk versus normal nutrition) was associated with significantly increased risk for mortality by the CONUT (adjusted hazard ratio [HR] 4.615, 95% confidence interval [CI] 1.373-15.514, P = 0.013), GNRI (adjusted HR 3.641, 95% CI 1.924-6.891, P < 0.001), and PNI score (adjusted HR 1.587, 95% CI, 1.096-2.297, P = 0.014). Furthermore, adding the malnutrition indexes to models modestly improved the predictive ability of mortality.Conclusions: Our study indicated that malnutrition was highly prevalent in older Chinese adults with ischemic stroke and associated with increased mortality. Further research is required to evaluate the efficacy of nutritional management in these patients. (c) 2021 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.