Association between energy intake and activities of daily living in patients with acute stroke at hospital discharge: a retrospective cohort study

Abstract

ABSTRACT Objective This study aimed to investigate the effects of energy intake on activities of daily living (ADL) in patients with acute stroke, with a focus on the differences between obese and non-obese patients. Methods This retrospective observational study was conducted in a neurological hospital and included patients hospitalized for acute stroke. During the acute phase (1 week after admission), energy intake was assessed, and the main outcome was defined as the Functional Independence Measure in the motor domain (FIM-M) at discharge. All subjects were divided into two groups based on their body mass index (BMI) at admission, with BMI ≥ 25 defining the obese stroke group and BMI < 25 defining the non-obese stroke group. Linear regression analysis was performed to examine the relationship between energy intake and FIM-M in each group. Results A total of 307 patients with acute stroke (median age: 72 years) were included in this study, with 118 patients (39%) in the obese stroke group. In the non-obese stroke group, a significant and independent relationship was observed between FIM-M and energy intake (β = 0.103, p = 0.031, adjusted R2 = 0.687). However, in the obese stroke group, no significant relationship was found between FIM-M and energy intake (β = 0.076, p = 0.302). Conclusion In patients with acute stroke, energy intake positively affects functional outcomes in non-obese patients but not in obese patients. This study highlights the importance of considering obesity as a potential factor in determining energy intake in patients with acute stroke.