Predictive Value of Nutritional Risk for All-Cause Death and Functional Outcomes in Chinese Elderly Patients with Acute Stroke: A 3-Year Follow-Up Study

IF 3.6 3区医学 Clinical Interventions in Aging Pub Date : 2024-01-17 DOI:10.2147/cia.s447038

Wen-Jie Cong, Zhi-Peng Liu, Yi-Xin Liang, Sheng-Lie Ye, Zhong-Ming Cai, Hao-Man Chen, Cheng-Wei Liao, Qun-Li Lin, Ren-Qian Feng, Xu-Dong Zhou, Yan-Zhi Wu, Le-Qiu Sun, Xue-Rong Huang, Man-Man Zhang, Gui-Qian Huang, Bei-Lei Zhu

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Abstract

Purpose: To explore the predictive value of nutritional risk for all-cause death and functional outcomes among elderly acute stroke patients.
Patients and Methods: A total of 479 elderly acute stroke patients were enrolled in this study. The nutritional risk of patients was screened by the GNRI and NRS-2002. The primary outcome was all-cause death, and the secondary outcome was poor prognosis defined as a modified Rankin Scale (mRS) score ≥ 3.
Results: Based on the NRS-2002, patients with nutritional risk had a higher risk of all-cause death at 3 months (adjusted OR: 3.642, 95% CI 1.046~12.689) and at 3 years (adjusted OR: 2.266, 95% CI 1.259~4.076) and a higher risk of adverse functional outcomes at 3 months (adjusted OR: 2.748, 95% CI 1.518~4.972. Based on the GNRI, compared to those without nutritional risk, patients with mild malnutrition also had a higher risk of all-cause death at 3 months (adjusted OR: 7.186, 95% CI 1.550~33.315) and at 3 years (adjusted OR: 2.255, 95% CI 1.211~4.199) and a higher risk of adverse functional outcomes at 3 months (adjusted OR: 1.947, 95% CI 1.030~3.680), so patients with moderate and severe malnutrition had a higher risk of all-cause death at 3 months (adjusted OR: 6.535, 95% CI 1.380~30.945) and at 3 years (adjusted OR: 2.498, 95% CI 1.301~4.799) and a higher risk of adverse functional outcomes at 3 months (adjusted OR: 2.213, 95% CI 1.144~4.279).
Conclusion: Nutritional risk increases the risk of poor short-term and long-term outcomes in elderly patients with acute stroke. For elderly stroke patients, we should pay attention to early nutritional risk screening, and effective intervention should be provided to improve the prognosis of such patients.

Keywords: acute stroke, malnutrition, nutritional screening, all-cause death, GNRI, NRS-2002

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营养风险对中国老年急性脑卒中患者全因死亡和功能预后的预测价值：3年随访研究

目的：探讨营养风险对老年急性脑卒中患者全因死亡和功能预后的预测价值：本研究共纳入 479 名老年急性脑卒中患者。患者和方法：本研究共纳入 479 名老年急性脑卒中患者，通过 GNRI 和 NRS-2002 筛选患者的营养风险。主要结果为全因死亡，次要结果为不良预后，即改良Rankin量表（mRS）评分≥3：根据 NRS-2002，营养风险患者 3 个月时全因死亡风险较高（调整 OR：3.642，95% CI 1.046~12.689），3 年时全因死亡风险较高（调整 OR：2.266，95% CI 1.259~4.076），3 个月时不良功能预后风险较高（调整 OR：2.748，95% CI 1.518~4.972）。根据 GNRI，与无营养风险的患者相比，轻度营养不良患者 3 个月时全因死亡的风险更高（调整 OR：7.186，95% CI 1.550~33.315），3 年时全因死亡的风险更高（调整 OR：2.255，95% CI 1.211~4.199），3 个月时出现不良功能预后的风险更高（调整 OR：1.947，95% CI 1.030~3.680），因此中度和重度营养不良患者3个月时全因死亡风险更高（调整后OR：6.535，95% CI 1.380~30.945），3年时全因死亡风险更高（调整后OR：2.498，95% CI 1.301~4.799），3个月时不良功能结局风险更高（调整后OR：2.213，95% CI 1.144~4.279）：结论：营养风险会增加老年急性卒中患者短期和长期不良预后的风险。对于老年脑卒中患者，我们应重视早期营养风险筛查，并提供有效干预以改善此类患者的预后。关键词：急性脑卒中；营养不良；营养筛查；全因死亡；GNRI；NRS-2002

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来源期刊

Clinical Interventions in Aging GERIATRICS & GERONTOLOGY-

CiteScore

6.20

自引率

2.80%

发文量

193

期刊介绍： Clinical Interventions in Aging, is an online, peer reviewed, open access journal focusing on concise rapid reporting of original research and reviews in aging. Special attention will be given to papers reporting on actual or potential clinical applications leading to improved prevention or treatment of disease or a greater understanding of pathological processes that result from maladaptive changes in the body associated with aging. This journal is directed at a wide array of scientists, engineers, pharmacists, pharmacologists and clinical specialists wishing to maintain an up to date knowledge of this exciting and emerging field.