Hospital-associated sarcopenia and the preventive effect of high energy intake along with intensive rehabilitation in patients with acute stroke

Abstract

ObjectivesHospital-associated sarcopenia is prevalent and associated with poor outcomes in acutely admitted patients. Prevention of developing sarcopenia during hospitalization is an important factor in stroke management. Therefore, this study aimed to investigate whether energy intake and rehabilitation duration contribute to the prevention of hospital-associated sarcopenia in patients with acute stroke. MethodsPatients with acute stroke were included in this study. Energy intake during the first week of hospitalization was classified as “high” or “low” based on the reported cutoff value. Rehabilitation time during hospitalization was classified as “intense” or “mild” based on the median. The four groups were compared based on the combinations of high or low energy intake and intense or mild rehabilitation. The primary outcome was the development of sarcopenia during hospitalization. The secondary outcome was the Functional Independence Measure motor item gain during hospitalization. Multivariate analysis was performed with the primary or secondary outcome as the dependent variable and the effect of each group on the outcome was examined. ResultsA total of 112 participants (mean age = 70.6 y; 63 men) were included in the study. Multivariate analysis found that high × intense (odds ratio = 0.113; P = 0.041) was independently associated with the development of sarcopenia during hospitalization (i.e., hospital-related sarcopenia). High × intense (β = 0.395; P < 0.001) was independently associated with the gain of Functional Independence Measure motor items. ConclusionsIn patients with acute stroke, the combination of high energy intake and adequate rehabilitation time is associated with prevention of hospital-associated sarcopenia.