Impact of nutritional status on long-term functional outcomes of post-acute stroke patients in Taiwan

Shen, Hsiu-Chu; Chen, Hsueh-Fen; Peng, Li-Ning; Lin, Ming-Hsien; Chen, Liang-Kung; Liang, Chih-Kuang; Lo, Yuk-Keung; Hwang, Shinn-Jang

doi:10.1016/j.archger.2010.08.001

« Previous Next »Archives of Gerontology and Geriatrics
Volume 53, Issue 2 , Pages e149-e152, September 2011

Impact of nutritional status on long-term functional outcomes of post-acute stroke patients in Taiwan

Hsiu-Chu Shen
- Division of Neurology, Department of Medicine, Kaohsiung Veterans General Hospital, No. 386, Ta-Chung 1st Road, Kaohsiung 81362, Taiwan
- Division of Neurology, Pingtung Christian Hospital, No. 60, Dalian Road, Pingtung 90059, Taiwan
Hsueh-Fen Chen
- Institute of Healthcare and Administratin, College of Public Health, National Taiwan University, No. 17, Shu-Chow Road, Taipei 10055, Taiwan
Li-Ning Peng
- Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, No. 201, Shih-Pai Road Sec. 2, Taipei 11217, Taiwan
- Department of Family Medicine, Taipei Veterans General Hospital, No. 201, Shih-Pai Road Sec. 2, Taipei 11217, Taiwan
- National Yang-Ming University School of Medicine, No. 155, Li-Nong Street, Sec. 2, Taipei 11217, Taiwan
Ming-Hsien Lin
- Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, No. 201, Shih-Pai Road Sec. 2, Taipei 11217, Taiwan
- Department of Family Medicine, Taipei Veterans General Hospital, No. 201, Shih-Pai Road Sec. 2, Taipei 11217, Taiwan
- National Yang-Ming University School of Medicine, No. 155, Li-Nong Street, Sec. 2, Taipei 11217, Taiwan
Liang-Kung Chen
- Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, No. 201, Shih-Pai Road Sec. 2, Taipei 11217, Taiwan
- Department of Family Medicine, Taipei Veterans General Hospital, No. 201, Shih-Pai Road Sec. 2, Taipei 11217, Taiwan
- National Yang-Ming University School of Medicine, No. 155, Li-Nong Street, Sec. 2, Taipei 11217, Taiwan
- Corresponding author at: Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, No. 201, Shih-Pai Road Sec. 2, Taipei 11217, Taiwan. Tel.: +886 2 2875 7460; fax: +886 2 2873 7901.
Chih-Kuang Liang
- Division of Neurology, Department of Medicine, Kaohsiung Veterans General Hospital, No. 386, Ta-Chung 1st Road, Kaohsiung 81362, Taiwan
- National Yang-Ming University School of Medicine, No. 155, Li-Nong Street, Sec. 2, Taipei 11217, Taiwan
Yuk-Keung Lo
- Division of Neurology, Department of Medicine, Kaohsiung Veterans General Hospital, No. 386, Ta-Chung 1st Road, Kaohsiung 81362, Taiwan
- National Yang-Ming University School of Medicine, No. 155, Li-Nong Street, Sec. 2, Taipei 11217, Taiwan
Shinn-Jang Hwang
- Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, No. 201, Shih-Pai Road Sec. 2, Taipei 11217, Taiwan
- Department of Family Medicine, Taipei Veterans General Hospital, No. 201, Shih-Pai Road Sec. 2, Taipei 11217, Taiwan
- National Yang-Ming University School of Medicine, No. 155, Li-Nong Street, Sec. 2, Taipei 11217, Taiwan

Received 3 May 2010; received in revised form 1 August 2010; accepted 3 August 2010. published online 01 September 2010.

Abstract

Nutritional status is important in stroke care, but little is known regarding to the prognostic role of nutritional status on long-term functional outcomes among stroke survivors. The main purpose of this study was to evaluate to the prognostic role of nutritional status on long-term functional outcomes among stroke survivors. Data of acute stroke registry in Kaohsiung Veterans General Hospital were retrieved for analysis. Overall, 483 patients (mean age=70.7±10.3 years) with first-ever stroke were found. Among them, 95 patients (19.7%) were malnourished at admission, 310 (mean age=70.4±10.1 years, 63.5% males) survived for 6 months, and 244 (78.7%) had good functional outcomes. Subjects with poor functional outcomes were older (74.7±8.9 vs. 69.0±10.1 years, p<0.001), more likely to be malnourished (56.2% vs. 26.6%, p<0.001), to develop pneumonia upon admission (23.3% vs. 12.7%, p=0.027), had a longer hospital stay (23.5±13.9 vs. 12.5±8.2 days, p<0.001), had a higher National Institutes of Health Stroke Scale (NIHSS) score (12.9±9.3 vs. 4.9±4.3, p<0.001), poorer stroke recovery (NIHSS improvement: 6.9% vs. 27.4%, p=0.005), and poorer functional improvement (Barthel index=BI improvement in the first month: 31.4% vs. 138%, p<0.001). Older age (odds ratio=OR)=1.07, 95% confidence interval (CI=1.03–1.11, p<0.001), baseline NIHSS score (OR=1.23, 95%CI=1.15–1.31, p<0.001) and malnutrition at acute stroke (OR=2.57, 95%CI: 1.29–5.13, p<0.001) were all independent risk factors for poorer functional outcomes. In conclusion, as a potentially modifiable factor, more attentions should be paid to malnutrition to promote quality of stroke care since the acute stage.