[The risk factors for malnutrition in post-stroke patients.].

OBJECTIVE: To investigate the detection rate of malnutrition among post-stroke patients in community hospitals and unravel the relevant factors that precipitate malnutrition after stroke. METHODS: Based on 438 post-stroke patients who were admitted in community hospitals, we examined the demographic characteristics, the nutritional indices and the possible malnutrition related factors through a cross-sectional study. RESULTS: The detection rate of malnutrition among post-stroke patients was 52.7%. Group comparison through multivariate logistic regression analysis showed that there was a higher malnutrition detection rate in the post-stroke patients with multiple stroke attacks (three stroke attackes and above, OR = 11.00, 95%CI 1.14 - 106.34), higher NIHSS scores (group with NIHSS >/= 15, OR = 7.09, 95%CI 2.90 - 17.36), higher modified Rankin scales (group mRS 4 - 5, OR = 15.77, 95%CI 6.61 - 37.59) (trend test P < 0.0001). The risk of malnutrition was also correlated with the post-stroke depression, poorer family care, no early-stage rehabilitation, history of malignant tumors and severe alcoholism. CONCLUSIONS: There is a high detection rate of malnutrition among post-stroke patients in community hospitals. There are many factors related to malnutrition among post-stroke patients in the community. More attention to controllable influencing factors would improve the prognosis of post-stroke patients.

[The impact of early alimentary nutrition on short-term prognosis after acute stroke].

OBJECTIVE: To discuss the short-term effects of early naso-gastric nutrition after acute stroke. METHODS: In a prospective non-randomized controlled design, 146 stroke patients with dysphagia were included. 75 patients in the intervention group received standard naso-gastric nutrition and 71 patients in the control group and received feeding supervised by family members. We observed the nutrition status, infective complications and mortality between the two groups for 21 days. Neurological deficit was evaluated with NIH stroke scale, Barthel index and the modified of Rankin Scale, the latter scale being calculated for 90 days. RESULTS: After 21 days, the nutritional parameters (triceps skin thickness, arm muscle circumference, haemoglobin, serum albumin, and triglycerides) in the intervention group were significantly better than those in the control group. Malnutrition was observed in 27.1% of the intervention group and 48.3% of the control group (P = 0.014). The incidence of infective complications was 33.3% in the intervention group and 52.1% in the control group (P = 0.022). Mortality rate was 6.7% in the intervention group and 18.1% in the control group (P = 0.032). The score of NIH stroke scale on the 21st day in the intervention group was also significantly better than that in the control group (P = 0.008). However, the Barthel index on the 21st day and the score of the modified Rankin Scale on the 90th day of follow-up were not statistically different between the two groups. CONCLUSIONS: It is suggested that standardized naso-gastric nutrition is helpful for improving short-term neurological function following acute stroke. However, improvement of Barthel index and the score of the modified Rankin Scale needs more therapeutic measures besides nutritional support.