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(Stroke. 2008;39:918.)
© 2008 American Heart Association, Inc.

Original Contributions

Weight Loss After Stroke

A Population-Based Study From the Lund Stroke Register

Ann-Cathrin Jönsson, RN, MSc, PhD; Ingrid Lindgren, RPT, MSc; Bo Norrving, MD, PhD Arne Lindgren, MD, PhD

From the Department of Neurology, Clinical Sciences Lund, Lund University, Lund, Sweden.

Correspondence to Ann-C. Jönsson, Department of Neurology, Lund University Hospital, S-221 85 Lund, Sweden. E-mail ann-cathrin.jonsson{at}skane.se

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 >3 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 >3 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/m². The main stroke types were cerebral infarction (89%), intracerebral hemorrhage (7%), and subarachnoid hemorrhage (4%). Weight loss >3 kg was found in 74 (24%) patients (mean, –6.6 kg) after 4 months and in 79 patients (26%; mean, –8.3 kg) 1 year later. Severe stroke and elevated glycosylated hemoglobin levels were baseline predictors of weight loss >3 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 >3 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.

Key Words: albumin • glycosylated hemoglobin • nursing care • malnutrition • outcome • prealbumin • stroke care • weight loss