Risk factors for malnutrition in stroke patients: A meta-analysis
Risk factors for malnutrition in stroke patients: A meta-analysis
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DOI：
10.1016/j.clnu.2017.12.014
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发表时间：
2019-02-01
影响因子：
6.3
通讯作者：
He, Li
中科院分区：
文献类型：
--
作者：
Chen, Ning;Li, Yanbo;He, Li
背景与目的：脑卒中是世界范围内常见的死亡和残疾原因。在中风患者中，营养不良是导致预后不良的一个重要问题。需要临床证据来确定营养不良的危险因素，并在早期卒中干预期间采取适当的管理策略。方法：系统检索MEDLINE、EMBASE、中国生物医学文献数据库（CBLD）、中国知网（CNKI）、维普中文期刊数据库（VIP）1990年1月至2017年9月期间的相关观察性研究，检索语种不限。本研究纳入的患者为患有卒中的成年人。使用Stata 12.0和Review Manager 5.1软件汇总有用数据并计算比值比（OR）及其95%置信区间（CI）。我们还进行了异质性和敏感性分析，并评估publication bias.Results：29项观察性研究，涉及8838名符合我们的纳入标准的参与者被纳入荟萃分析，13个与营养不良相关的危险因素进行了研究。以下变量可能与卒中患者营养不良风险增加相关：入院时营养不良（OR = 8.34，95%CI = 4.60-15.10，P < 0.00001），吞咽困难（OR = 2.60，95%CI = 2.24-3.03，P < 0.00001），既往脑卒中史（OR = 3.04，95%CI = 2.35-3.95，P < 0.00001），糖尿病（OR = 1.79，95%CI = 1.35-2.38，P < 0.0001），管饲（OR = 5.43，95% CI = 3.99-7.37，P < 0.00001）和意识下降（OR = 2.82，95% CI = 2.12-3.75，P < 0.00001）。饮酒、高血压、男性、抑郁情绪、肺炎和感染等因素需要重新评估。相反，吸烟是最有可能不与中风后nutritions.Conclusions：我们的荟萃分析揭示了各种风险因素的营养不良住院期间中风患者。早期识别这些因素是改善患者预后的必要条件。(C)2017 Elsevier Ltd和欧洲临床营养与代谢学会。All rights reserved.
Background & aims: Stroke is a common cause of death and disability worldwide. Among stroke patients, malnutrition is a significant problem that contributes to poor outcome. Clinical evidence is required to identify risk factors for malnutrition and to adopt appropriate management strategies during early stroke intervention. Thus, we performed a meta-analysis of potential risk factors related to malnutrition in stroke patients.Methods: We systemically searched relevant observational studies in MEDLINE, EMBASE, Chinese Biomedical Literature Database (CBLD), China National Knowledge Infrastructure (CNKI), and VIP Database of Chinese periodicals from January 1990 to September 2017 in any language. Patients included in this study were adults who suffered from stroke. Stata 12.0 and Review Manager 5.1 software were used to pool useful data and calculate odds ratios (ORs) and their 95% confidence intervals (CIs). We also performed heterogeneity and sensitivity analyses, and evaluated publication bias.Results: Twenty-nine observational studies involving 8838 participants who met our inclusion criteria were incorporated into the meta-analysis, and thirteen risk factors related to malnutrition were studied. The following variables probably correlated with an increased risk of malnutrition in stroke patients: malnutrition on admission (OR = 8.34, 95% CI = 4.60-15.10, P < 0.00001), dysphagia (OR = 2.60, 95% CI = 2.24-3.03, P < 0.00001), previous stroke (OR = 3.04, 95% CI = 2.35-3.95, P < 0.00001), diabetes mellitus (OR = 1.79, 95% CI = 1.35-2.38, P < 0.0001), tube feeding (OR = 5.43, 95% CI = 3.99-7.37, P < 0.00001) and reduced level of consciousness (OR = 2.82, 95% CI = 2.12-3.75, P < 0.00001). The factors alcohol consumption, hypertension, male sex, depressed mood, pneumonia and infection need to be re-evaluated. Conversely, smoking was most likely not associated with post-stroke malnutrition.Conclusions: Our meta-analysis has revealed a variety of risk factors for malnutrition during hospital stay among stroke patients. Early identification of these factors is warranted for improving patient outcomes. (C) 2017 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.