The association between nutritional intake one week after admission and outcome in acute ischemic stroke patients
The association between nutritional intake one week after admission and outcome in acute ischemic stroke patients
复制标题
DOI：
10.1016/j.jstrokecerebrovasdis.2022.106812
复制
发表时间：
2022-09-29
影响因子：
2.5
通讯作者：
Maruyama, Hirofumi
中科院分区：
文献类型：
--
作者：
Eto, Futoshi;Nezu, Tomohisa;Maruyama, Hirofumi
目的：尽管已确定卒中入院时营养不良状况与不良卒中结局之间的关联，但急性期营养摄入的影响仍不清楚。我们的目的是评估急性缺血性卒中（AIS）患者入院后一周的营养摄入量与三个月后的结局之间的关联。材料和方法：对连续的 AIS 患者进行了调查。使用控制营养状况评分评估入院时的营养状况，该评分根据血清白蛋白、淋巴细胞计数和总胆固醇计算。我们回顾性评估入院一周后的营养摄入量（能量和蛋白质），并使用接受者操作特征曲线将每个营养摄入水平良好结局的临界值定义为卒中发病后三个月的改良Rankin量表0-2。结果：205例患者中，146例患者预后良好。轻微的初始神经症状和入院时良好的营养状况与良好的预后相关。蛋白质摄入量良好结果的截止值为 0.812 g/kg/天（敏感性：0.884，特异度：0.509），能量摄入量良好结果的截止值为 19.0 kcal/kg/天（敏感性：0.918，特异度：0.424）。调整基线混杂因素后，这些营养摄入指标与良好结局独立相关，包括卒中严重程度和入院时的营养状况（蛋白质摄入量：比值比（OR），4.04；95%置信区间（CIs），1.14-13.1；能量摄入：OR，5.00；95% CIs，1.41-17.8）。结论：无论入院时的营养状况或卒中严重程度如何，入院后一周的充足营养摄入与良好结局独立相关。 (c) 2022 Elsevier Inc. 保留所有权利。
Objectives: Although associations between malnutrition status at stroke admission and poor stroke outcomes have been established, the effect of nutritional intake during the acute phase remains unclear. We aimed to evaluate the associations between nutritional intake one week after admission and the outcome at three months among acute ischemic stroke (AIS) patients. Materials and methods: Consecutive AIS patients were investigated. Nutritional status at admission was evaluated using the Controlling Nutritional Status score, calculated from the serum albumin, lymphocyte count, and total cholesterol. We retrospectively evaluated nutritional intake (energy and protein) one week after admission, and the cutoff value of each nutritional intake level for good outcome was defined as the modified Rankin Scale 0-2 at three months after stroke onset using the receiver operating characteristic curve. Results: Of the 205 patients, 146 patients had good outcomes. Mild initial neurological symptoms and good nutritional status at admission were associated with good outcome. The cutoff value of good outcome for protein intake was 0.812 g/kg/day (sensitivity: 0.884, specificity: 0.509) and that for energy intake was 19.0 kcal/kg/ day (sensitivity: 0.918, specificity: 0.424). Those nutritional intake indicators were independently associated with good outcome after adjusting for baseline confounders, including stroke severity and nutritional status at admission (protein intake: odds ratio (OR), 4.04; 95% confidence intervals (CIs), 1.14-13.1, and energy intake: OR, 5.00; 95% CIs, 1.41-17.8, respectively). Conclusions: Adequate nutritional intake at one week after admission was independently associated with good outcome regardless of the nutritional status at admission or stroke severity. (c) 2022 Elsevier Inc. All rights reserved.