Weight Loss After Stroke

Abstract

Background and Purpose-Data on the prevalence and indicators of weight loss in population-based groups of stroke survivors are scarce. We aimed to find the predictors and indicators of weight loss Ͼ3 kg as a possible marker of malnutrition after stroke. Methods-We registered weight at baseline, after 4 months, and 1 year later in 305 survivors from a population-based cohort of first-ever stroke patients. Characteristics of the patients were registered at baseline and follow-ups, including glycosylated hemoglobin at baseline and follow-up II, eating difficulties at both follow-ups, and screening for depression at follow-up II. We used univariate and multivariate analyses to find baseline predictors and follow-up indicators related to weight loss Ͼ3 kg from baseline. Results-Among the 305 patients, 60% were male, the mean age was 72.5 years, and mean body mass index was 25.8 kg/m 2 . The main stroke types were cerebral infarction (89%), intracerebral hemorrhage (7%), and subarachnoid hemorrhage (4%). Weight loss Ͼ3 kg was found in 74 (24%) patients (mean, Ϫ6.6 kg) after 4 months and in 79 patients (26%; mean, Ϫ8.3 kg) 1 year later. Severe stroke and elevated glycosylated hemoglobin levels were baseline predictors of weight loss Ͼ3 kg. Indicators associated with short-term weight loss (at follow-up I) were eating difficulties, low prealbumin value, and dependence (Barthel Index), whereas indicators associated with long-term weight loss (follow-up II) were eating difficulties, hemorrhagic stroke, and low prealbumin value. Conclusions-Weight loss Ͼ3 kg after stroke indicates the need for closer observation regarding nutritional status.Monitoring of body weight may be useful, particularly among patients with severe stroke, eating difficulties, low prealbumin values, and impaired glucose metabolism.

Superiority of Preventive Antibiotic Treatment Compared with Standard Treatment of Poststroke Pneumonia in Experimental Stroke: A Bed to Bench Approach

“…However, preventively treated mice regained their body weight faster than mice from other treatment groups. In patients, weight loss is correlated with poor functional outcome, 33 hence faster weight recovery might also be partially related to the improved functional outcome in preventively treated mice.…”

Catabolic Signaling and Muscle Wasting After Acute Ischemic Stroke in Mice

“…6 Nutritional deficits are common in patients with stroke, 7 and weight loss of ≥3 kg is associated with higher mortality. 5 Muscle wasting in acute and subacute stroke may result from direct metabolic, inflammatory, and hormonal signals. 8 Systemic sympathomimetic activation and bacterial infections are also common after acute stroke, both carrying catabolic signals.…”

Altered Taste and Stroke: A Case Report and Literature Review

“…Those identified as having eating difficulties were more likely to experience significant weight loss at 4-month follow-up. 28 Weight loss often coincides with malnutrition in the setting of critical illness, leading to increased risk of poststroke complications, 29 including gastrointestinal bleeding, pneumonia, and other infections. 29,30 Acute stroke patients who are malnourished are at risk for poorer outcomes, 28 independent of baseline nutritional status and age, [29][30][31] and are also at risk for continued undernourishment during hospitalization.…”

“…28 Weight loss often coincides with malnutrition in the setting of critical illness, leading to increased risk of poststroke complications, 29 including gastrointestinal bleeding, pneumonia, and other infections. 29,30 Acute stroke patients who are malnourished are at risk for poorer outcomes, 28 independent of baseline nutritional status and age, [29][30][31] and are also at risk for continued undernourishment during hospitalization. 32 Patients with eating difficulties on admission have been shown to require longer hospital admissions and are more likely to require institutionalized care following discharge.…”