Prestroke Nutritional Status

The prevalence of protein-energy malnutrition at the time of hospital admission following stroke has been variably reported as 8-30%. More detailed information obtained within 4 days of hospital admission has classified 9% of stroke patients as undernourished, 16% as overweight, and 75% as of normal nutritional status, based on a range of observational and nutritional assessment techniques. In relation to stroke outcomes at 6 months, the presence of under-nutrition shortly after admission has been independently associated with a significantly greater mortality and increased likelihood of developing pneumonia, other infections, and gastrointestinal bleeds before hospital discharge. Furthermore, patients of normal nutritional status have been found to be less likely to develop pressure sores than those who were undernourished or overweight. Specifically, a low serum albumin concentration has been found to be a significant predictor of post-stroke functional impairment, morbidity, and mortality. Risk factors for malnutrition identified at the time of hospital admission have included increasing age, living alone, dementia, and inadequate dental status. These findings are consistent with those found in wider surveys of elderly populations where risk factors for protein-energy malnutrition also included social isolation, bereavement, poverty, physical disability, inadequate facilities for preparing and cooking food, and the impact of multiple medications on appetite. The presence of malnutrition in older adults may be associated with impaired immune responses, increasing vulnerability to pneumonia and sepsis following hospital admission. The significance of a low serum albumin concentration in predicting clinical outcomes has been noted in other geriatric populations, where it may be more a reflection of disease severity than an indicator of nutritional status.

Your Heart and Nutrition

Your Heart and Nutrition

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