Relationship of Malnutrition During Hospitalization With Functional Recovery and Postdischarge Destination in Elderly Stroke Patients
Relationship of Malnutrition During Hospitalization With Functional Recovery and Postdischarge Destination in Elderly Stroke Patients
复制标题
DOI：
10.1016/j.jstrokecerebrovasdis.2019.04.012
复制
发表时间：
2019-07-01
影响因子：
2.5
通讯作者：
Mutai, Hitoshi
中科院分区：
文献类型：
--
作者：
Sato, Masaaki;Ido, Yoshikazu;Mutai, Hitoshi
目的：住院期间营养不良影响老年脑卒中患者的功能恢复和出院后目的地。然而，关于这一人群急性卒中期住院期间营养状况的研究不足。本研究探讨老年脑卒中急性期患者住院期间营养状况变化的影响因素，并探讨营养状况变化与日常生活能力改善及出院后去向的关系。方法：这项回顾性观察性研究纳入了2010-2016年在信州大学医院住院的205例急性期卒中患者。进行多元回归分析，以确定营养状况变化，患者特征和改善的日常生活活动之间的关系。采用二项logistic回归分析确定出院后目的地与营养状况变化之间的关系。结果：入院时营养不良的患病率为42%，出院时为76%。影响入院时营养状况变化的因素包括老年营养风险指数（β =-0.35，P < .001）和Barthel指数/喂养（β = 0.22，P = .002），住院期间的因素包括年龄（β =-0.21，P <0.001）、缺血性卒中（β = 0.16，P = 0.008）和国立卫生研究院卒中量表评分（β =-0.29，P <0.001）。老年营养风险指数的变化与住院期间日常生活活动的改善（β = 0.26，P <0.001）和出院回家（比值比= 1.11，95%置信区间：1.03-1.19，P = 0.008）显著相关。结论：许多老年脑卒中急性期营养不良患者在住院期间病情恶化，这与他们的日常生活能力和出院后目的地呈负相关。必须在住院期间对该患者人群的营养状况变化和相关因素进行评估。
Aim: Malnutrition during hospitalization affects the functional recovery and postdischarge destinations of elderly stroke patients. However, insufficient studies exist about nutritional status during hospitalization in the acute stroke phase in this population. This study determined factors of nutritional status changes during hospitalization in elderly patients in the acute phase of stroke, and investigated the relationship between nutritional status changes and improved activities of daily living and postdischarge destination. Methods: This retrospective observational study included 205 acute-phase stroke patients admitted to Shinshu University Hospital from 2010-2016. Multiple regression analysis was conducted to determine relationships between nutritional status changes, patient characteristics, and improved activities of daily living. Binomial logistic regression analysis was used to determine the relationship between the postdischarge destination and nutritional status changes. Results: Prevalence of malnutrition was 42% at admission and 76% at discharge. Factors affecting nutritional status changes at admission included Geriatric Nutritional Risk Index (beta = -0.35, P < .001) and Barthel Index/feeding (beta = 0.22, P = .002), and factors during hospitalization included age (beta = -0.21, P < .001), ischemic stroke (beta = 0.16, P = .008), and National Institute of Health Stroke Scale score (beta = -0.29, P < .001). Significant associations of changes in geriatric nutritional risk index occurred with improved activities of daily living during hospitalization (beta = 0.26, P < .001) and discharge to home (odds ratio = 1.11, 95% confidence interval: 1.03-1.19, P = .008). Conclusion: Many elderly patients in the acute phase of stroke with malnutrition exhibited worsening conditions during hospitalization, which was negatively associated with their activities of daily living abilities and postdischarge destinations. Nutritional status changes and associated factors must be evaluated during hospitalization in this patient population.