Malnutrition in stroke patients on the rehabilitation service and at follow-up: Prevalence and predictors

Abstract

This prospective study presents the prevalence and risk factors of malnutrition in 49 consecutive stroke patients on the rehabilitation (Rehab) service and at 2- to 4-month follow-up. Malnutrition was diagnosed using biochemical and anthropometric data. Stroke patients, on admission to Rehab, have a very high prevalence of malnutrition. Malnutrition, 49% on admission, declined to 34%, 22%, and 19% at 1 month, 2 months, and follow-up, respectively. Dysphagia, 47% on admission, was associated with malnutrition ( p = .032) and significantly declined over time. Using logistic regression, predictors of malnutrition on admission involved acute service tube feedings ( p = .002) and histories of diabetes ( p = .027) and prior stroke ( p = .013). Tube feedings, associated with malnutrition on admission ( p = .043), were more prevalent in brain stem lesion patients. Patients tube fed ≥ 1 month during rehabilitation or at home were not malnourished. Malnutrition was associated with advanced (>70 years) age at 1 month ( p = .002) and weight loss ( p = .011) and lack of community care ( p = .006) at follow-up. Early and ongoing detection and treatment of malnutrition are recommended during rehabilitation of stroke patients both on the service and at follow-up.