Background
The aim of the present study was to establish whether high nutritional-related risk
on admission predicts less improvement of Functional Independence Measure (FIM) in
geriatric stroke patients.
Methods
We performed a retrospective cohort study of patients admitted for stroke at 5 major
hospitals in the Noto district of Japan from July 2009 to June 2013. Patients were
divided into 2 groups according to Geriatric Nutritional Risk Index (GNRI) at admission.
Patient characteristics were compared between the low GNRI (<92) and high GNRI (≥92)
groups. We assessed nutritional status using GNRI and activities of daily living using
the FIM.
Results
A total of 540 participants (mean age, 80 years; interquartile range, 75-85 years)
were included in the present study. Patients were admitted because of cerebral infarction
(394 patients), intracerebral hemorrhage (123 patients), and subarachnoid hemorrhage
(23 patients). Univariate analysis of FIM gain demonstrated significant differences
between groups. Multivariate analysis of FIM gain adjusting for confounding factors
demonstrated age (β = −.139; 95% confidence interval [CI] = −.629 to −.140), cerebral
infarction (β = −.264; 95% CI = −12.956 to −6.729), National Institutes of Health
Stroke Scale (β = −.180; 95% CI = −.688 to −.248), and GNRI score (β = .089; 95% CI = .010-.347)
as independent factors associated with FIM gain (P < .05 for all).
Conclusions
GNRI at admission may independently predict FIM gain. Poor nutritional status is a
predictor of lower FIM improvement in geriatric stroke patients.
Key Words
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Article info
Publication history
Published online: March 14, 2016
Accepted:
January 31,
2016
Received in revised form:
January 16,
2016
Received:
October 8,
2015
Footnotes
Authors' contributions: Yoji Kokura: conception and design of the study; generation, collection, assembly, analysis, and interpretation of data; drafting of the manuscript; and approval of the final version of the manuscript. Hidetaka Wakabayashi, Keisuke Maeda, Shinta Nishioka, Sotaro Higashi: conception and design of the study; analysis and interpretation of data; revision of the manuscript; and approval of the final version of the manuscript.
Identification
DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2016.01.048
Copyright
© 2016 National Stroke Association. Published by Elsevier Inc. All rights reserved.
