Abstract 2428: Nutritional Predictors Of Long-term Clinical Outcome In Patients Fed Through A Gastro-intestinal Tube Following Serious Acute Stroke.
Purpose The purpose of our retrospective study was to find nutritional predictors of long-term clinical outcome in patients fed through a gastro-intestinal tube following serious acute stroke.
Methods Included were acute stroke patients as follows, 1) who were admitted to our institution from January 2008 to December 2009, 2) who undertook gastro-intestinal tube feeding due to serious neurological deficits. Patients who were comatose condition, suffered from gastro-intestinal bleeding or severe aspiration pneumonia on admission were excluded. Evaluated were patient’s baseline characteristics (age, gender, stroke subtype), NIHSS (NIH), albumin (ALB), total cholesterol (T-CHO), total lymphocyte count (TLC) and CONUT (CONtrolling NUTritional status: CON) score on admission (adm) and on the 7th day (7th). Correlation between variables and 3M-mRS was analyzed univariately and multivariately.
Results During the study period, consecutive 805 acute stroke patients were admitted to our institution, 150 patients among them were included for analysis. The average age was 80.1±12.3 (±SD) years old, 68 were men (45.3%), and 103 were infarction(68.7%). There were statistically significant correlations between 3M-mRS and Age (ρ=0.309), NIH adm (ρ=0.357), CON adm (ρ=0.231), ALB adm (ρ=0.281), NIH 7th (ρ=0.498), CON 7th (ρ=0.496), ALB 7th (ρ=0.433), T-CHO 7th (ρ=0.309)(p<0.01) and TLC 7th (ρ=0.174) (p<0.05) in univariate analysis. Logistic regression analysis demonstrated that Age and CON 7th were independent nutritional predictors of 3M-mRS (p<0.01), and the cut-off value of CON 7th for good clinical outcome (3M-mRS: 0-2) was 3 by using ROC curve (AUC: 0.794, p=0.001, 74% of sensitivity, 73% of specificity).
Conclusions In serious acute stroke patients who had to undertake gastrointestinal-tube feeding, the CONUT score on the 7th day was the independent nutritional predictor of 3-month clinical outcome. In order to achieve favorable clinical outcome at 3 month, nutrition management within 7 days of stroke onset is very important and CONUT score on the 7th day must be 3 or less.
- © 2012 by American Heart Association, Inc.