Nutrition in the Stroke Patient

Abstract

Malnutrition is common both before and after stroke, with dysphagia adding to nutrition risk. Many patients require specialized nutrition support in the acute phase and beyond when swallowing function does not improve or return to allow for nutrition autonomy. When neurologic deficits improve, assessment of the swallowing function, introduction of dysphagia diets, and specialized swallowing techniques are used to transition away from enteral feeding tubes to oral diets. This article reviews the evaluation and treatment of dysphagia, use of specialized nutrition support, strategies for weaning enteral tube feedings, and the impact of nutrition on quality of life in the stroke patient population.

Swallowing rehabilitation with nutrition therapy improves clinical outcome in patients with dysphagia at an acute care hospital

“…On the other hand, malnutrition becomes more prevalent during post-acute rehabilitation phase (18)(19)(20), suggesting the importance of nutrition support. Dysphagia has been associated with increased mortality and morbidity (1).…”

Malnutrition Rate In Stroke Patients On Admission

“…[12] Diabetes mellitus and a history of stroke increased the risk for malnutrition on admission by 58 and 71%, respectively. [4,13] Comorbidities were not a significant risk factor for malnutrition in our study. This finding is in agreement with that of a Swedish study showing that the BMI of 231 patients with dementia did not differ, regardless of whether they had no/mild or severe morbidities.…”

“…It is estimated that about fifth of patients with acute stroke are malnourished on admission. [1] In our study 52% of the stroke patients were malnour- [4,5] In the study male patients younger than 65 years of age were more likely malnourished. Although women are more susceptible than men to undernourishment, this result may be because they suffer stroke at an older age than men.…”

“…Indicators of malnutrition include serum levels of albumin, prealbumin, and transferrin; total lymphocyte count; body weight and body mass index; triceps skinfold thickness; midarm muscle circumference. [4] Hepatic proteins such as albumin, prealbumin, and transferin are commonly used as markers to evaluate nutrition status. They are influenced by many non-nutrition factors.…”

Stroke unit treatment: long-term effects

“…early nasogastric tube feeding in the presence of aspiration risk and (ii.) percutaneous e ndoscopic gastrostomy tube feeding if impairment of oral intake is likely to persist for more than 4 weeks [47,48].…”