Individualized nutritional treatment for acute stroke patients with malnutrition risk improves functional independence measurement: A randomized controlled trial

Otsuki, Ikuto; Himuro, Nobuaki; Tatsumi, Hiroomi; Mori, Mitsuru; Niiya, Yoshimasa; Kumeta, Yukihiro; Yamakage, Michiaki

doi:10.1111/ggi.13854

Cited by 18 publications

(7 citation statements)

References 29 publications

(57 reference statements)

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“…From the 4277 identified references, 325 full articles were screened, and 63 articles [ 13 – 75 ] describing 60 RCTs were included in our review (Fig. 1 ).…”

Section: Resultsmentioning

confidence: 99%

Towards developing a Core Outcome Set for malnutrition intervention studies in older adults: a scoping review to identify frequently used research outcomes

Visser

Mendonça

Avgerinou³

et al. 2022

Eur Geriatr Med

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Purpose To conduct a scoping review to provide a systematic overview of outcomes used in nutritional intervention studies focused on the treatment of protein-energy malnutrition in older adults. Methods A systematic search of four electronic databases (Medline, EMBASE, CINAHL and Cochrane Central Register of Controlled Trials (CENTRAL) was performed to retrieve randomized controlled trials (RCTs), published until March 9, 2020, that evaluated the effect of nutritional interventions to treat protein-energy malnutrition in older adults and those at risk for malnutrition. Two authors screened titles, abstracts and full texts independently. One author extracted data that were cross-checked by another author. Results Sixty-three articles reporting 60 RCTs were identified. Most frequently used outcomes included body weight/body mass index (75.0% of RCTs), dietary intake (61.7%), functional limitations (48.3%), handgrip strength (46.7%), and body circumference (40.0%). The frequencies differed by setting (community, hospital and long-term care). For some outcomes there was a preferred assessment method (e.g., Barthel index for functional limitations), while for other outcomes (e.g., functional performance) a much greater variation was observed. Conclusion A large variation in outcomes, not only across but also within settings, was identified in nutritional intervention studies in malnourished older adults and those at risk. Furthermore, for many outcomes there was a large variation in the used assessment method. These results highlight the need for developing a Core Outcome Set for malnutrition intervention studies in older adults to facilitate future meta-analyses that may enhance our understanding on the effectiveness of treatment.

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“…From the 4277 identified references, 325 full articles were screened, and 63 articles [ 13 – 75 ] describing 60 RCTs were included in our review (Fig. 1 ).…”

Section: Resultsmentioning

confidence: 99%

Towards developing a Core Outcome Set for malnutrition intervention studies in older adults: a scoping review to identify frequently used research outcomes

Visser

Mendonça

Avgerinou³

et al. 2022

Eur Geriatr Med

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“…These two indicators will also be affected by the activity status after onset. The present study also used the Harris–Benedict equation to calculate the caloric requirement of patients, which was used by Otsuki et al and improved the activities of daily living of older stroke patients in acute phase with malnutrition risk ( 26 ). The assessment of OD and individualized nutrition intervention in this study was performed mainly by nurses under the guidance and supervision of rehabilitation therapists and dietitians.…”

Section: Discussionmentioning

confidence: 99%

Individualized Nutritional Support for Hospitalized Patients With Oropharyngeal Dysphagia After Stroke: A Randomized Controlled Trial

et al. 2022

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ObjectivesPost-stroke dysphagia may cause aspiration pneumonia, malnutrition, dehydration, and other complications. However, data on the effects of nutritional supplementation and its value after stroke are insufficient. We aimed to evaluate the effect of an individualized 1-week nutrition intervention program on swallowing function and nutritional status in stroke patients with oropharyngeal dysphagia.MethodsThis study comprised the control group receiving oral nutritional support and continuous nasogastric tube feeding according to the results of the water swallow test (WST). The intervention group additionally underwent a volume-viscosity swallowing test (V-VST) and intermittent oroesophageal tube feeding based on WST. The outcomes were measured after 7 days of intervention, including the improvement of swallowing function assessment by WST, biochemical parameters, such as total serum protein, serum albumin, hemoglobin levels and body composition. This trial was registered with the Chinese Clinical Trial Registry, identifier ChiCTR 2100054054.ResultsIn total, 173 participants completed the study between September 1, 2020, and April 30, 2021. Patients receiving individualized nutritional support showed a more significant improvement in the total effective rate of swallowing function (95.3% vs. 85.1%, P < 0.05). After the intervention, the total serum protein level (0.97 ± 0.41 vs. −0.83 ± 0.47 g/L; P < 0.05), serum albumin level (0.33 ± 0.28 vs. −1.39 ± 0.36 g/L; P < 0.001) and lean tissue mass (0.13 ± 0.35 vs. −1.00 ± 0.40 g/L; P < 0.05) increased in the intervention group. The decrease of hemoglobin levels in the control group was more evident (−6.17 ± 1.63 vs. −0.64 ± 1.40 g/L; 95%CI, −9.78 to −1.28; P = 0.001). The difference of phase angle between the two groups was statistically significant (5.93 ± 0.88° vs. 5.77 ± 0.78°; P = 0.035), but not in body fat mass.ConclusionsIn stroke patients with oropharyngeal dysphagia, the use of individualized nutritional support based on V-VST and intermittent oroesophageal tube feeding during the first week of hospitalization improved swallowing function and maintained nutritional status.Clinical Trial Registrationhttps://clinicaltrials.gov/, identifier: ChiCTR 2100054054.

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“…Furthermore, AHS survivors are vulnerable to malnutrition. Individualised nutritional treatment has been associated with improved outcomes in activities of daily living in stroke patients at risk of malnutrition (26,27) . Thus, early screening and identification of individuals who are at malnutrition risk are vital to ensure that the timeing nutritional managements may contribute to more benefits for the functional recovery in AHS clinical practice.…”

Section: Discussionmentioning

confidence: 99%

A prospective epidemiological analysis of controlling nutritional status score with the poor functional outcomes in Chinese patients with haemorrhagic stroke

Zhu

Cai

et al. 2021

Br J Nutr

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Nutritional Risk Screening index is a standard tool to assess nutritional risk, but epidemiological data are scarce on Controlling Nutritional Status (CONUT) as a prognostic marker in acute hemorrhagic stroke (AHS). We aimed to explore whether the CONUT may predict a 3-month functional outcome in AHS. In total, 349 Chinese patients with incident AHS were consecutively recruited, and their malnutrition risks were determined using a high CONUT score of ≥ 2. The cohort patients were divided into high-CONUT (≥ 2) and low-CONUT (< 2) groups, and primary outcomes were a poor functional prognosis defined as the modified Rankin Scale (mRS) score of ≥ 3 at post-discharge for 3 months. Odds ratios (OR) with 95% confidence intervals (CI) for the poor functional prognosis at post-discharge were estimated by using a logistic analysis with additional adjustments for unbalanced variables between the high-CONUT and low-CONUT groups. A total of 328 patients (60.4 ± 12.83 years; 66.8% male) completed the mRS assessment at post-discharge for 3 months, with 172 patients at malnutrition risk at admission and 104 patients with a poor prognosis. The levels of total cholesterol and total lymphocyte counts were significantly lower in high-CONUT patients than low-CONUT patients (p = 0.012 and < 0.001, respectively). At 3-month post discharge, there was a greater risk for the poor outcome in the high-CONUT compared with the low-CONUT patients at admission (OR: 2.32, 95% CI: 1.28-4.17). High-CONUT scores independently predict a 3-month poor prognosis in AHS, which helps identify those who need additional nutritional managements.

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Individualized nutritional treatment for acute stroke patients with malnutrition risk improves functional independence measurement: A randomized controlled trial

Cited by 18 publications

References 29 publications

Towards developing a Core Outcome Set for malnutrition intervention studies in older adults: a scoping review to identify frequently used research outcomes

Towards developing a Core Outcome Set for malnutrition intervention studies in older adults: a scoping review to identify frequently used research outcomes

Individualized Nutritional Support for Hospitalized Patients With Oropharyngeal Dysphagia After Stroke: A Randomized Controlled Trial

A prospective epidemiological analysis of controlling nutritional status score with the poor functional outcomes in Chinese patients with haemorrhagic stroke

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