Malnutrition on admission increases the in‐hospital mortality and length of stay in elder adults with acute ischemic stroke

Hao, Ruixiao; Qi, Xiaoqiong; Xia, Xiaoshuang; Wang, Lin; Li, Xin

doi:10.1002/jcla.24132

Cited by 20 publications

(20 citation statements)

References 48 publications

(62 reference statements)

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“…All the studies applying the CONUT tool to stroke patients were carried out (since 2018) in Far Eastern Countries, with the exception of one from Spain [ 14 , 15 , 17 , 20 , 22 , 23 , 25 , 26 , 30 , 33 , 34 , 36 , 40 , 41 , 44 , 45 , 46 , 56 , 60 , 61 , 66 , 67 , 68 , 69 , 70 , 71 , 72 ], as reported in Table 1 . Stroke patients were classified according to the original four, but also in three (normal, light, and moderate/severe risk) or in two (absence or presence of risk) categories; a CONUT score ≥5 was commonly defined as the cut-off for a significant risk of malnutrition, but in two papers the cut-off was ≥2 [ 72 ] or ≥4 [ 23 ], respectively.…”

Section: Nutritional Screening Toolsmentioning

confidence: 99%

“…Outcomes related to hospitalization and discharge have been considered by a few papers, showing that CONUT score/categories were associated with in-hospital mortality, LOS, infection, nutritional support, length of rehabilitation, and independence in ADL at discharge [ 17 , 26 , 33 , 70 , 72 ]. One study [ 26 ] evaluated AIS and an age-matched control group represented by hospitalized patients admitted to a hospital for disorders not related to acute stroke; it reported higher CONUT scores, higher in-hospital mortality, and longer LOS in AIS patients. In a convalescent ward, CONUT score was a predictor of the length of stay but not of changes in functional independence [ 30 ].…”

Section: Nutritional Screening Toolsmentioning

confidence: 99%

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The Assessment of the Risk of Malnutrition (Undernutrition) in Stroke Patients

et al. 2023

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Malnutrition is common in stroke patients, as it is associated with neurological and cognitive impairment as well as clinical outcomes. Nutritional screening is a process with which to categorize the risk of malnutrition (i.e., nutritional risk) based on validated tools/procedures, which need to be rapid, simple, cost-effective, and reliable in the clinical setting. This review focuses on the tools/procedures used in stroke patients to assess nutritional risk, with a particular focus on their relationships with patients’ clinical characteristics and outcomes. Different screening tools/procedures have been used in stroke patients, which have shown varying prevalence in terms of nutritional risk (higher in rehabilitation units) and significant relationships with clinical outcomes in the short- and long term, such as infection, disability, and mortality. Indeed, there have been few attempts to compare the usefulness and reliability of the different tools/procedures. More evidence is needed to identify appropriate approaches to assessing nutritional risk among stroke patients in the acute and sub-acute phase of disease or during rehabilitation; to evaluate the impact of nutritional treatment on the risk of malnutrition during hospital stay or rehabilitation unit; and to include nutritional screening in well-defined nutritional care protocols.

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Section: Nutritional Screening Toolsmentioning

confidence: 99%

Section: Nutritional Screening Toolsmentioning

confidence: 99%

The Assessment of the Risk of Malnutrition (Undernutrition) in Stroke Patients

et al. 2023

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“…The prevalence of malnutrition in patients hospitalized for stroke ranges from 1.95% to 60.5%, depending on the assessment tool and diagnostic criteria [ 4 5 6 ]. Studies have reported that nutritional status at the time of stroke and traumatic brain injury affects the progress of acute-stage treatment [ 4 7 8 9 ]. Malnutrition during rehabilitation affects the progress of medical treatment and is associated with increased rates of mortality, readmission, and discharge to other institutions and higher medical costs [ 6 10 11 ].…”

Section: Prevalence Of Malnutrition In Patients With Neurological Dis...mentioning

confidence: 99%

The Importance of Nutrition in Neurological Disorders and Nutrition Assessment Methods

Lee

2022

Brain Neurorehabil

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Neurological disorders can change patients’ nutritional status by directly or indirectly affecting dietary intake through mechanisms such as dysphagia, movement disorders, cognitive impairment, and depression. Malnutrition contributes to complications, resulting in delayed rehabilitation and increased morbidity and mortality. It is important to prevent malnutrition in patients with neurological disorders and to improve their nutritional status by identifying nutritional deterioration at an early stage and implementing appropriate nutritional interventions. This review examines the nutritional screening and assessment process in patients with neurological disorders, with a particular focus on stroke patients undergoing rehabilitation. Nutritional assessment, the first step of clinical nutrition management, identifies nutritional problems and their causes, signs, and symptoms through an overall evaluation including anthropometric measurements, dietary assessments, biochemical assessment, nutrition-related physical examinations, and functional assessment data. Based on the assessment, a nutritional intervention plan is established. By synthesizing the assessment results of selected subjective and objective indicators, nutritional screening tools to screen patients at risk of malnutrition and nutritional assessment tools to diagnose malnutrition were developed. It is important to use those tools with a clear understanding of their characteristics and scope.

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“…To date, fewer studies have been produced about in-hospital short-term outcomes such as the LOS or 30-day re-admission rates in medical units. A recent monocentric Chinese study performed by Hao in 2022 demonstrated that a higher CONUT score predicts a higher LOS and in-hospital mortality, specifically in patients with ischemic stroke [ 24 ]; another recent, large multicenter retrospective study performed in China in older adults, collecting data from more than eleven thousand patients, demonstrated that a higher CONUT score predicts a longer LOS and in-hospital mortality in elderly patients [ 25 ]. However, similar studies concerning LOS or in-hospital mortality in more heterogeneous cohorts of patients or in Western countries are still lacking.…”

Section: Introductionmentioning

confidence: 99%

COntrolling NUTritional Status (CONUT) as Predictive Score of Hospital Length of Stay (LOS) and Mortality: A Prospective Cohort Study in an Internal Medicine and Gastroenterology Unit in Italy

et al. 2023

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Background: Hospital malnutrition affects nearly 30% of patients in medical wards and correlates with worse outcomes. An early assessment is necessary to stratify the risk of short-term outcomes and mortality. The predictive role of COntrolling NUTritional status (CONUT) score in this context has not yet been elucidated in Western countries. We aimed to test CONUT at admission as a predictive score of hospital outcomes, in an Internal Medicine and Gastroenterology Department of an Italian Tertiary Care University hospital. Methods: We prospectively enrolled patients admitted to our center, stratifying them into the four CONUT classes (normal = 0–1; mild = 2–4; moderate = 5–8; severe = 9–12 points) according to serum albumin (g/dL), total lymphocyte count (/mm3), and total cholesterol (mg/dL); the primary outcome measure was length of stay (LOS) and the secondary one was in-hospital mortality. Results: Out of a total of 203 patients enrolled, 44 (21.7%) patients had a normal status (0–1), 66 (32.5%) had a mild impairment (2–4), 68 (33.5%) had a moderate impairment (5–8), and 25 (12.3%) a severe impairment (9–12). The mean LOS was 8.24 ± 5.75 days; nine patients died. A moderate-severe CONUT correlated with a higher LOS at the univariate [HR 1.86 (95% CI 13.9–3.47); p < 0.0001] and multivariate analysis [HR 1.52 (95% CI 1.10–2.09); p = 0.01]. The CONUT score was also a predictor of mortality, with an AUC of 0.831 (95% CI 0.680–0.982) and with an optimal cut-off at 8.5 points. Nutritional supplementation within 48 h from admission correlated with lower mortality [OR 0.12 (95% CI 0.02–0.56) p = 0.006]. Conclusions: CONUT is a reliable and simple predictor of LOS and in-hospital mortality in medical wards.

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Malnutrition on admission increases the in‐hospital mortality and length of stay in elder adults with acute ischemic stroke

Cited by 20 publications

References 48 publications

The Assessment of the Risk of Malnutrition (Undernutrition) in Stroke Patients

The Assessment of the Risk of Malnutrition (Undernutrition) in Stroke Patients

The Importance of Nutrition in Neurological Disorders and Nutrition Assessment Methods

COntrolling NUTritional Status (CONUT) as Predictive Score of Hospital Length of Stay (LOS) and Mortality: A Prospective Cohort Study in an Internal Medicine and Gastroenterology Unit in Italy

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