The effect of protein and calorie intake on prealbumin, complications, length of stay, and function in the acute rehabilitation inpatient with stroke

Abstract

BACKGROUND: Nutrition's impact on stroke rehabilitation outcomes is controversial. Existing studies utilize albumin without correcting for inflammation in nutritional assessments. Here, prealbumin was used and inflammation assessed to determine if nutrition impacts rehabilitation outcomes. OBJECTIVE: Determine the effect of dietary intake on prealbumin level, number of complications, length of stay, and Functional Independence Measure (FIM) efficiency in rehabilitation stroke inpatients. METHODS: Patients had admission and discharge prealbumin and C-reactive protein (CRP) levels drawn; and, weekly protein and calorie counts obtained. Patients were followed for number of complications, length of stay, and FIM efficiency. RESULTS: Mean protein and calorie intake was 57.6 ± 16.2 g/d and 1452.2 ± 435.8 kcal/d, respectively. 77.6% of patients had normal prealbumin on admission with 94.9% on discharge. Prealbumin increased significantly from admission to discharge (22.3 ± 6.2 mg/dL vs. 24.6 mg/dL ± 5.1 mg/dL, P = 0.007). Number of complications and length of stay were predicted by CRP in regression models. Total, motor, and cognitive FIM efficiencies were not universally affected by prealbumin levels, protein intake, or calorie intake. CONCLUSIONS: Nearly all hypoprealbuminemic stroke rehabilitation inpatients correct their levels eating a non-supplemented diet. Number of complications, length of stay, and functional outcomes in this patient are not affected by prealbumin levels, protein intake, or calorie intake.

Nutritional intake is associated with activities of daily living and complications in older inpatients with stroke

“…8 In contrast, Pellicane et al reported improvement of ADL as not universally affected by energy intake. 13 In addition, they reported that energy intake during the acute stage did not affect the onset of complications during hospitalisation. 13 Currently, there is no consensus on energy intake in the acute stage and improvement in ADL, and there are few reports on energy intake and the onset of complications during hospitalization.…”

“…13 In addition, they reported that energy intake during the acute stage did not affect the onset of complications during hospitalisation. 13 Currently, there is no consensus on energy intake in the acute stage and improvement in ADL, and there are few reports on energy intake and the onset of complications during hospitalization. These previous studies were single facility studies with few participants not distinguishing between stroke types.…”

A quick and improvement effect of leucine enriched dietary supplement on malnutrition in acute stroke patients receiving enteral tube feeding

“…Inflammation must be attenuated as soon as possible. However, it has not been established on how to improve hypoproteinemia rapidly [9]. Larger volumes of protein intake in the diet do not always lead to rapid improvement of hypoproteinemia and cessation of inflammation, probably due to the dysfunction of protein synthesis in a severe clinical state [10] [11].…”

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

“…In contrast, Pellicane et al reported that improvement in the ADL was not associated with energy intake. 15 The mechanisms of neurological recovery after stroke comprise local processes (early recovery) and central nervous system reorganization (later recovery). Early recovery includes resolution of poststroke edema, reperfusion of the ischemic penumbra and resolution of diaschisis in the first few weeks.…”

“…In contrast, Pellicane et al . reported that improvement in the ADL was not associated with energy intake …”